The posteromedial thigh (PMT) flap for lower extremity reconstruction

Abstract

BACKGROUND: The posteromedial thigh (PMT) perforator flap is a new reliable flap with versatility. The purpose of this article was to report our experience with the use of free PMT flaps for reconstruction of defects of the lower extremity. PATIENTS AND METHODS: From July 2014 to May 2015, 8 patients received reconstruction with 8 free PMT flaps. The defect locations included the heel (1 case), dorsal foot (2 cases), plantar foot (1 case), lateral malleolus (1 case), Achilles tendon (1 case), and tibia (2 cases). Flaps were raised based on the first medial perforator of the profunda femoris artery (PFA) (7 cases) and medial circumflex femoral artery (LCFA) perforator (1 case). The dorsalis pedis artery (3 cases), anterior tibia artery (1 cases), posterior tibial artery (3 cases), and medial sural pedicle (1 case) were dissected as recipient vessels. RESULTS: The flap sizes varied from 10 × 10 to 30 × 11 cm. All the flaps survived completely after surgery. The donor sites were all primarily closed with minimal morbidities. Follow-up observations were conducted for 3-12 months, and all patients had good functional recovery with satisfactory cosmetic results. CONCLUSION: Perforators arising from the PFA in the posterior medial thigh can be used to design pliable fasciocutaneous flaps. The pedicle length and the vessel diameter are adequate for microvascular anastomosis to the lower extremities recipient vessels. The free PMT flap serves as a good new option for reconstructing lower extremity defects. © 2016 Wiley Periodicals, Inc. Microsurgery 37:865-872, 2017.