The cutaneous territory of the transverse tensor fascia lata flap: further anatomical considerations.

The cutaneous territory and the anatomical variations of the lateral circumflex femoral artery (LCFA) were studied on 20 fresh cadavers. This territory extends transversally on an average of 20 per 18 cm on the supero-lateral aspect of the thigh. The LCFA divides into three terminal branches as it enters the tensor fascia lata muscle. The posterior transverse branch is constant and makes the transverse tensor fascia lata (TFL) flap highly reliable, as opposed to the classical longitudinal TFL flap. The latter is based on the descending branch of the LCFA which is missing in 5 out of 20 cadavers. The lateral circumflex femoral artery also gives 1 to 2 ascending branches running toward the iliac crest and providing its periosteal blood supply. Based on these branches, it might be possible to raise an osteomyocutaneous flap of tensor fascia lata and iliac crest.