Ascending the reconstructive ladder - Our experience and outcomes with free anterolateral thigh flap in upper limb trauma.

[BACKGROUND] Reconstructive surgeons face a unique challenge while reconstructing post-traumatic complex upper limb defects, as the goal is not merely to resurface the defect but also to restore motor and sensory function as well as aesthetics. Free tissue transfer offers a single-stage, comprehensive reconstruction in such a setting. This study describes our experience in the use of the free Anterolateral Thigh (ALT) flap to reconstruct complex upper limb defects and its postoperative outcomes.

[METHODS] A cohort of 17 patients who underwent free ALT flap for upper limb reconstruction was assessed postoperatively at 3 and 6 months for aesthetic, functional and sensory outcomes.

[RESULTS] Key findings include a high overall success rate (94.1 %) with acceptable patient and observer-reported aesthetic scores, a good functional recovery at 6 months, a mean disability score of 11.51 %, and a mean grip strength of 90.38 % compared to the contralateral limb.

[CONCLUSION] The study highlights the effectiveness of free ALT flap in providing reliable, high-quality soft tissue coverage with minimal donor site morbidity. The study also reinforces its preference for the reconstruction of complex upper limb trauma, supporting excellent functional recovery, thereby ensuring an early return to work and a better quality of life.