Anatomy of the lobulated anterolateral thigh myocutaneous flap pedicled with the descending branch of the lateral femoral circumflex artery

Objective To provide anatomical basis for the design and application of the lobulated anterolateral thigh myocutaneous flap pedicled with the descending branches of the lateral femoral circumflex artery.Methods 20 fresh lower extremities,with artery injecting of red lactoprene,were used in this study.The entry sites of the descending branches into the vastus lateralis muscle,and the branches,distribution and the anastomosis of vessels in the muscle were explored.Results(1) Descending branches mainly(80.8%) came from the lateral femoral circumflex artery,with the average external diameter of(3.7±0.9) mm.the artery laid deep the rectus femoris muscle,and ran downwards along the anterior border of the vastus lateralis muscle,and branched into medial and lateral branches under the starting point about(9.0±3.5)cm.(2)The lateral branches,with the average length of the vascular pedicle of(8.1±3.3)cm,supplied the vastus lateralis muscle,which gave off 6.7 branches averagely to the vastus lateralis muscles and the skin of the anterolateral thigh.The average diameter of it was about 1.0mm,and the distance between the neighboring branches was about(1.9±0.9) cm.(3) There were(2.5±1.2) cutaneous branches appeared in the anterolateral thigh area with the diameter of(0.8±0.3) mm,and in these branches,23.8% were spatium intermusculare perforators and 76.2% musculo-cutaneous perforators.High cutaneous artery branches were found in 15 cases(57.7 %).Conclusions(1) Utilizing the different branches,the lobulated anterolateral thigh myocutaneous flap can be designed,and the space between the flaps can be adjusted according to the shape and the location of the recipient site.(2)The lobulated anterolateral thigh myocutaneous flap pedicled with the descending branch of the lateral femoral circumflex artery is an ideal selection to restore the complex wounds.