Arch Hand Microsurg 2019; 24(2): 167-176  
Usefulness of Anterolateral Thigh Flap for Severe Trauma Patients at the Regional Trauma Center
Sung Min Hong1, Yong Jin Kim1, Sang Ho Kwak2, Dong Hee Kim3, Hee Jin Lee4, Seung Joon Rhee4, Tae Young Ahn4, Sang Hyun Lee4
1Centum Institute for Hand and Microsurgery, West Busan Centum Hospital, Busan, Korea
2Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea
3Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
4Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
Correspondence to: Sang Hyun Lee
Department of Orthopaedic Surgery, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
TEL: +82-51-240-7248, FAX: +82-51-247-8395, E-mail: handsurgeon@naver.com
Received: August 3, 2018; Revised: April 24, 2019; Accepted: April 29, 2019; Published online: June 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The purpose of the research is to identify the result of using anterolateral thigh (ALT) flap to multiple trauma patients with open fracture accompanying soft tissue injuries.
Methods: The subjects were 18 patients who visited the regional trauma center with open fracture and treated with the ALT flap from February 2013 to September 2017. According to the injured body regions, there were 7 cases of foot injuries, 5 of lower extremity, 3 of ankle, 2 of hand, and 1 of forearm. The cause of injuries was car accidents in 10 cases including the pedestrian struck in 4 cases.
Results: Except for one case that the patient’s flap was lost due to the artery thrombosis, the rest of cases showed that the flap was survived. Average healing time to a bone union was 8.1 months.
Conclusion: During the surgery of the multiple trauma patients with open fracture, no change of patient position is required and no pressure to abdomen or chest was applied. Also, the ALT flap with relatively long pedicle seems to be more useful than other flap surgeries.
Keywords: Multiple traumas, Open fracture, Free flaps


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