Neurovascular Anatomy

The lateral thigh flap is based on the third perforator of the profunda femoris artery. The profunda femoris artery gives off several branches that course in a posterolateral direction to supply the lateral thigh musculature and overlying skin. However, the third perforator is usually the dominant blood supply to the lateral thigh skin encompassed by the flap (Fig. 67). The length of the vascular pedicle (third perforator plus the profunda femoris artery up to the second perforator) may be up to 10 cm while the diameters of the artery and vein may be as large as 4 mm and 5 mm, respectively. Sensation can be restored to the flap via the lateral femoral cutaneous nerve. This nerve passes under the inguinal ligament where it divides into an anterior branch and a posterior branch. The posterior branch pierces the fascia lata and distributes posteriorly in the upper thigh. The anterior branch distributes along the anterolateral thigh within the territory of the lateral thigh flap.

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