DOI: 10.36347/sajb.2018.v06i02.001

Pages: 141-145

The latero-distal cutaneous flap of the thigh is one of the few local flaps that can be used for loss of substance of the anterior aspect of the knee, a delicate area to be covered by exposure of the patella and knee joint. Our study aimed to study the anatomical bases of this flap, in particular its arterial vascularization based on perforators. Our study took place in the anatomy laboratory of the Catholic University of Louvain in Brussels. We dissected 43 knees by performing an internal paramedian incision of the posterior face of the knee, supplemented by 2 transverse counter-incisions to detach the skin from the latero-distal part of the thigh. Fasciocutaneous perforators were studied as well as the superior lateral genicular artery (SLGA). On 9 other knees, we first injected a dye into the SLGA to observe the impregnated cutaneous territory before proceeding to the dissection. Of the 52 knees, the cutaneous perforator from the SLGA was present in 75% of cases. This perforator emerged from the fascia lata between the ilio-tibial tract in front and the lateral intermuscular septum back on average at 40.2 ± 7.5mm slightly forward and above the epicondyle. In the absence of a perforator from the SLGA, substitution was provided by other cutaneous perforators from vascular branches of the biceps femoris or vastus lateralis muscles. Of the 9 knees injected, 2 knees did not have dermal impregnation of the dye. For impregnated cases, the colored territory covered at least the lateral pre-patellar area, the lateral face of the knee ranging from 1.5 to 4 cm below the lateral epicondyle to 5.3 to 11 cm above the epicondyle. The SLGA very often gives a cutaneous perforator irrigating the skin of the latero-distal part of the thigh. This septo-cutaneous perforator is supplied by perforators from the vascular branches of neighboring muscles. The cutaneous territory irrigated by the SLGA extends to the distal third - two-thirds proximal union of the thigh.