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Case Reports
. 2025 Sep 16;13(9):e7116.
doi: 10.1097/GOX.0000000000007116. eCollection 2025 Sep.

Anterolateral Thigh Flap With Kiss Technique for Major Joint Contracture

Sasagu Yagi  1 , Hiroyuki Takasu  1 , Sawa Taguchi  1 , Soichi Furukawa  2 , Nao Ono  1 , Miyako Nakahama  3
Affiliations
Case Reports

Anterolateral Thigh Flap With Kiss Technique for Major Joint Contracture

Sasagu Yagi et al. Plast Reconstr Surg Glob Open. .

Abstract

The anterolateral thigh (ALT) flap is one of the methods for treating joint contractures. However, the design of the ALT flap has not been sufficiently discussed. Herein, we describe our kiss ALT flap design for treating postburn joint contractures with satisfactory results. The patient is a 33-year-old man with scar contractures caused by flame burns in various areas of his body. We performed a kiss ALT flap transfer on a particularly symptomatic right knee. Postoperatively, the patient had no complications, and the joint range of motion improved. The key to designing our kiss ALT flap is to split the long ALT flap diagonally. The advantages of this design are that the dog ear can be used effectively, the flap size matches the skin defect at the joint, and the joint between the 2 divided flaps matches the joint fossa. The same technique has been used to treat axillary scar contractures with good results. A split ALT flap with the kiss technique for major joint contractures may be useful when 2 or more perforating vessels are available.

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Conflict of interest statement

The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Preoperative image of the patient with limited knee extension ability due to scar contracture.
Fig. 2.
Fig. 2.
The 30 × 6 cm ALT flap that was harvested from the left thigh and divided into 2 portions.
Fig. 3.
Fig. 3.
Image taken 6 months postoperatively showing improvement in the range of motion of the knee. The ALT flap does not appear bulky.
Fig. 4.
Fig. 4.
Schematic overview of the surgical procedure. A, A long ALT flap containing 2 perforating branches divided diagonally. Two flaps can be used without causing any dog ears. P1 and P2 in the figure represent perforators 1 and 2, respectively. B, Division such that each paddle contains a perforating branch. The 2 divided flaps were placed side-by-side as a kiss flap. C, Cutting directly above the scar contracture and releasing the contracture. D, The defect is wider in the center and narrower at both ends. E, The widest part of the flap corresponds to the widest part of the defect.
See this image and copyright information in PMC

References

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