ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication

We present two cases of acute compartment syndrome (ACS) in the donor area of an anterolateral thigh (ALT) flap, with extensive necrosis of the quadriceps muscle. An innervated latissimus dorsi (LD) flap was used to cover the defect and restore functionality of the lower extremity. ACS in the ALT do...

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Main Authors: Gloria Alsina, Teresa Nunez-Villaveirán, Daniel Camporro, Clara Martin
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2025-04-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1795149
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author Gloria Alsina
Teresa Nunez-Villaveirán
Daniel Camporro
Clara Martin
author_facet Gloria Alsina
Teresa Nunez-Villaveirán
Daniel Camporro
Clara Martin
author_sort Gloria Alsina
collection DOAJ
description We present two cases of acute compartment syndrome (ACS) in the donor area of an anterolateral thigh (ALT) flap, with extensive necrosis of the quadriceps muscle. An innervated latissimus dorsi (LD) flap was used to cover the defect and restore functionality of the lower extremity. ACS in the ALT donor area is extraordinarily uncommon. Its mechanism seems to be multifactorial, being more frequent in young athletic males and, possibly, in patients with anatomical vascular variations. It is important to detect it promptly to prevent irreversible muscular ischemia. Intense pain is an alarm sign but might be absent in patients with epidural infusion pumps. We recommend caution with the use of this analgesia and frequent monitoring of the donor area during the early postoperative period. The free functional LD muscle flap is an option to treat full-thickness quadriceps damage, allowing for wound closure, soft-tissue coverage, and restoration of the knee extension movement.
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spelling doaj-art-fdacf6b092e14aceafc6f4982bda5afd2025-08-20T03:09:45ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2025-04-01580212813110.1055/s-0044-1795149ALT Donor Area Compartment Syndrome: A Rare and Devastating ComplicationGloria Alsina0Teresa Nunez-Villaveirán1https://orcid.org/0000-0003-3899-8235Daniel Camporro2https://orcid.org/0000-0002-6196-8360Clara Martin3Plastic Surgery Unit, Mutua Sanitaria Mutual MC, Barcelona, SpainPlastic Surgery Unit, Hospital General de Granollers, Barcelona, SpainDepartment of Plastic Surgery, Hospital Universitario Central de Asturias, SpainDepartment of Plastic Surgery, Hospital Universitario Central de Asturias, SpainWe present two cases of acute compartment syndrome (ACS) in the donor area of an anterolateral thigh (ALT) flap, with extensive necrosis of the quadriceps muscle. An innervated latissimus dorsi (LD) flap was used to cover the defect and restore functionality of the lower extremity. ACS in the ALT donor area is extraordinarily uncommon. Its mechanism seems to be multifactorial, being more frequent in young athletic males and, possibly, in patients with anatomical vascular variations. It is important to detect it promptly to prevent irreversible muscular ischemia. Intense pain is an alarm sign but might be absent in patients with epidural infusion pumps. We recommend caution with the use of this analgesia and frequent monitoring of the donor area during the early postoperative period. The free functional LD muscle flap is an option to treat full-thickness quadriceps damage, allowing for wound closure, soft-tissue coverage, and restoration of the knee extension movement.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1795149compartment syndromeALT flapmicrosurgeryquadriceps reconstruction
spellingShingle Gloria Alsina
Teresa Nunez-Villaveirán
Daniel Camporro
Clara Martin
ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
Indian Journal of Plastic Surgery
compartment syndrome
ALT flap
microsurgery
quadriceps reconstruction
title ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
title_full ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
title_fullStr ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
title_full_unstemmed ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
title_short ALT Donor Area Compartment Syndrome: A Rare and Devastating Complication
title_sort alt donor area compartment syndrome a rare and devastating complication
topic compartment syndrome
ALT flap
microsurgery
quadriceps reconstruction
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1795149
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AT teresanunezvillaveiran altdonorareacompartmentsyndromearareanddevastatingcomplication
AT danielcamporro altdonorareacompartmentsyndromearareanddevastatingcomplication
AT claramartin altdonorareacompartmentsyndromearareanddevastatingcomplication