Abstract

Background:  Major defects in soft tissue due to many causes (after removal of benign or malignant tumors, burn scars or sequelae of wounds, trauma, etc.) are a challenge for plastic surgeons. In particular, osteoarthritis in the ankle area, due to pathology, leaves nerve, tendon, and bone complications and serious sequelae on the function and aesthetics of the limb area. The surgical procedures in the ankle area are covered with local materials according to the shaping steps, however, in large surgical procedures with exposed tendons, bones, and complex structures, they cannot be applied. The anterolateral thigh flap (ALT) is a perforator artery flap widely used to cover defects. However, this technique is still limited in lower-level hospitals.

Case report:  60-year-old male patient with a warty tumor on the front of his left ankle, diagnosed with skin cancer, histopathological results suspected squamous cell cancer. The doctor decided to cut widely according to the standards of squamous cell cancer, coordinating with Orthopedic Traumatology - Plastic surgery to cover the defect after cutting the tumor; 7×9cm using a free flap of the ALT. Patients with regular follow-up visits every month, 3 months, and 6 months after surgery had good results (Oberlin C and Duparc J).

Conclusions: The ALT-free flap is a material for shaping complex defects and is a safe, reliable, and satisfactory choice for the reconstruction of soft tissue ankle defects.