Clinical study of the superthin anterolateral thigh flap for reconstruction of post-traumatic ankle joint soft-tissue defects.

Xiang, Feifan; Lin, Jiaru; Chen, Bo; Luo, Lin · J Foot Ankle Surg · 2026

retrospective_cohort · Level III

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Abstract

To compare the superthin (3-5 mm) versus conventional (≥10 mm) anterolateral thigh (ALT) flap for post-traumatic ankle reconstruction. Retrospective cohort (2020-2024): superthin ALT (n=26) vs conventional ALT (n=34). Outcomes included flap survival, vascular crisis, ankle range of motion (ROM), AOFAS score, aesthetics, and clinical parameters. Complete flap survival (84.6% vs 94.1%, p=0.78) and partial survival (15.4% vs 5.9%, p=0.27) showed no significant differences. Arterial/venous crisis rates were also similar (8% vs 3%, p=0.43; 15% vs 6%, p=0.27). At 6 months, the superthin group had significantly better ankle ROM and AOFAS scores, comparable to the healthy contralateral side. Despite longer operative time, the superthin group reported higher satisfaction, better inflammation control, less scar hypertrophy, and superior pain control. Flap survival did not differ significantly between groups. The superthin ALT flap offers superior functional and cosmetic outcomes, making it a valid option for ankle soft-tissue reconstruction. Level 3.