Three-dimensional reconstruction strategy for infrared thermography-assisted perforator localization of pedicled anterolateral thigh flap in limb joint composite tissue defects
Objective To explore the three-dimensional reconstruction method and clinical outcomes of using infrared thermography-assisted pedicled anterolateral thigh myocutaneous flap with perforator for joint composite tissue defect repair.Methods A retrospective analysis was conducted on clinical data from January 2019 to December 2023,involving 16 patients with joint composite tissue defects treated at our hospital.Infrared thermography was used to assist in the precise positioning of the perforators for the pedicled anterolateral thigh myocutaneous flap.Among them,5 cases were accompanied by a small amount of bone defects in the joint area,and 1 case was accompanied by tendon defects.The wound area was 24 cm × 11 cm to 6 cm × 3 cm,the flap size was 20 cm × 6 cm to 6 cm × 3 cm,and the fascia flap area was 6.0 cm ×4.0 cm to 3.0 cm × 1.5 cm.The fascia lata and skin flap in the donor area were sutured directly.Results A total of 48 perforators were explored preoperatively,with 45 being confirmed intraoperatively,yielding a positive rate of 93.4％.All 16 patients were follow-up for a period ranging from 1 to 35 months,with an average of 9.4 months.All flaps survived without complications,exhibiting soft texture and satisfactory appearance.During the follow-up period,there were no signs of sinus formation,swelling,or pain in the joint area,and joint mobility was not significantly impaired.Two patients reported localized flap swelling during follow-up,and secondary thinning procedures were performed in these cases.Conclusion Infrared thermography-assisted perforator localization for pedicled anterolateral thigh myocutaneous flap is a safe and reliable three-dimensional reconstruction method for joint composite tissue defects.It represents an ideal approach for the reconstruction of joint composite tissue defects.
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