الفهرس 
Comprehensive Lower Limb AnatomyOnly 14 pages are availabe for public view
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Abstract
The advantage of free tissue transfer has provided multiple options for difficult defects of the lower extremities that allow the preservation and maintain the functional and aesthetic status of the limb. Since the first report of the anterolateral thigh flap by Song and colleagues in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft tissue defects. The flap has gained popularity because it has a large cutaneous area and a long vascular pedicle with a suitable vessel diameter with acceptable donor site morbidity. Also, the thickness of the flap can be adjusted. It can be combined with neighboring muscles and flaps when additional bulkiness or multiple tissue components are needed. The flap can be designed in a flow-through manner, interposing the pedicle between vascular gaps in an extremity. The operation can be carried out by 2 teams working simultaneously for most distal lower-extremity defects.
In this thesis, a study was made to study & evaluate indications, advantages, disadvantages and complications of reconstruction of complex soft-tissue defects in the lower extremities using free anterolateral thigh perforator flap.
This study was carried out on 21 patients diagnosed to have complex soft tissue defects in the lower extremities; the ages of the studied group varied from 6 to 49 years. There were 15 males and 6 females, the cause of the soft tissue defects in the lower limb was trauma, unstable graft, scar contracture and chronic osteomyelitic wound.
The site of the defect was middle third leg in 2 patients, lower third leg in 6 patients, dorsum of the foot in 7 patients, and heel & sole This study was carried out on 21 patients diagnosed to have complex soft tissue defects in the lower extremities; the ages of the studied group varied from 6 to 49 years. There were 15 males and 6 females, the cause of the soft tissue defects in the lower limb was trauma, unstable graft, scar contracture and chronic osteomyelitic wound.
The site of the defect was middle third leg in 2 patients, lower third leg in 6 patients, dorsum of the foot in 7 patients, and heel & sole in 6 patients. The size of the defects that were covered ranged in size from 6-25 cm in length and 4-15 cm in width.
The time to do the operation was ranged from the second day after the etiology of the defect till seven years and the duration of the operation ranged from 6 h. till 10 h.
The recipient arteries for microvascular anastomosis were anterior tibial artery in 4 cases (21%), posterior tibial artery in 14 cases (73.7%) and dorsalis pedis artery in 1 case (5.3%), all microvascual arterial anastomosis was end to end arterial anastomosis.
Regarding to the size of the flap; the length ranged from 7-27 cm and the width ranged from 4-15 cm. the duration of the flap elevation varies from 90 min to 180 min with, the donor site of the flap has been closed directly in 11 cases and by STSG in 8 cases.
There were one case (5.3 %) in which total flap failure has been occurred and another one case with partial flap loss (5.3 %); conservative management by dressing and NPWT was done for both cases then STSG, the other 17 case were totally survived.
All patients were followed up post-operatively for a period of up to 1 year and were evaluated according to the final result of the reconstruction from the functional and aesthetic point of view.