{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:00Z","timestamp":1777927380892,"version":"3.51.4"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The anterolateral thigh flap (ALT) is a reliable soft tissue reconstruction option, especially for lower extremity defects. Recent advancements in flap innervation methods show promise in promoting sensory recovery, yet the current literature lacks a comprehensive summary of its outcomes.<\/jats:p>\n                  <jats:p>A systematic review of PubMed, Embase, Web of Science, and Scopus was performed by identifying all studies examining sensory recovery outcomes in lower extremity reconstruction using innervated ALT flaps.<\/jats:p>\n                  <jats:p>Of 793 unique articles, eight studies (n\u2009=\u2009206 patients) met the inclusion criteria. The mean age was 47.9\u2009\u00b1\u200911.1 (range: 6\u201380). The most common etiologies of soft tissue defect were trauma (n\u2009=\u200994, 45.6%), diabetic foot ulcers (n\u2009=\u200964, 31.1%), and malignancy (n\u2009=\u200945, 21.8%). There were 108 (52.4%) patients who underwent reconstruction with a neurotized ALT flap, and 98 (47.6%) without. Of patients with neurotized flap reconstruction, nerve coaptation was performed end-to-end (n\u2009=\u200931, 28.7%) or end-to-side (n\u2009=\u200914, 12.9%). Recipient nerves included the medial plantar (n\u2009=\u200916, 14.8%), medial dorsal cutaneous (n\u2009=\u20099, 8.3%), calcaneal (n\u2009=\u20097, 6.5%), posterior tibial (n\u2009=\u20095, 4.6%), superficial peroneal (n\u2009=\u20094, 3.7%), or sural (n\u2009=\u20091, 0.9%) nerves. The overall complication rate was 16.5%, of which 11 (5.3%) were major flap complications requiring a return to the operating room. Overall, three studies found evidence of improved sensory recovery when using neurotized ALT flaps.<\/jats:p>\n                  <jats:p>Lower extremity reconstruction with innervated ALT flaps predominantly involves the foot and ankle region (98.5%), as the improved sensory recovery may be helpful in reducing secondary injury risk, such as diabetic foot ulcers. No cases involving reconstruction of soft tissue defects above the knee were identified.<\/jats:p>","DOI":"10.1055\/a-2858-3815","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:42:42Z","timestamp":1777675362000},"source":"Crossref","is-referenced-by-count":0,"title":["Sensory Recovery of Foot and Ankle Reconstruction with Neurotized ALT Flaps: A Systematic Review"],"prefix":"10.1055","author":[{"given":"Alec J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"},{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel A.","family":"Snee","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"},{"name":"Georgetown University School of Medicine, Washington, District of Columbia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"},{"name":"Department of Surgery, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Khong","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth K.","family":"Laning","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitae E.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily R.","family":"Mundy","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron M.","family":"Dingle","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8751-7309","authenticated-orcid":false,"given":"Samuel O.","family":"Poore","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"issue":"37","key":"ref1","doi-asserted-by":"crossref","first-page":"e38763","DOI":"10.1097\/MD.0000000000038763","article-title":"Surgical refinements and sensory and functional outcomes of using thinned sensate anterolateral thigh perforator flaps for foot and ankle reconstruction: A retrospective study","volume":"103","author":"Z Pan","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"ref2","first-page":"489012","article-title":"Aesthetic and functional outcomes of the innervated and thinned anterolateral thigh flap in reconstruction of upper limb defects","volume":"2014","author":"C A Torres-Ort\u00edz Zerme\u00f1o","year":"2014","journal-title":"Plast Surg Int"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"103691","DOI":"10.1016\/j.breast.2024.103691","article-title":"The efficacy of sensory nerve coaptation in DIEP flap 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Mahmoud","year":"2017","journal-title":"J Foot Ankle Surg"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2858-3815.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:42:47Z","timestamp":1777675367000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2858-3815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":37,"URL":"https:\/\/doi.org\/10.1055\/a-2858-3815","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}