Skip to main content

Advertisement

SpringerLink
Log in

The accessory vascularization of the tensor fasciae latae muscle: towards a new classification?

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The tensor fasciae latae (TFL) muscle is supplied by the lateral femoral circumflex artery (LCFA), arising from the deep femoral artery. However, it has been noted that there is also a consistent vascular anastomotic network. The aim of this study was to describe the accessory vascularization of the TFL muscle through a descriptive anatomical study, in order to hypothesize the feasibility of harvesting a TFL flap in the event of an injury to the main pedicle. In addition, we illustrate this hypothesis with a successful clinical case of Scarpa freconstruction following ligature of the deep femoral artery.

Methods

The description of the accessory vascularization was obtained by injecting dye into seven lateral femoral circumflex arteries (LCFA), six superficial circumflex iliac arteries (SCIA), and three inferior gluteal arteries (IGA).

Results

The TFL muscle was vascularized primarily by the LCFA. A vascular anastomotic network with the SCIA and the IGA was observed. After selective injection to the SCIAs and IGAs, the subsequent injection to the LCFA showed a diffusion of the TFL skin paddle with a perforasome overlapping between the different vascular territories.

Conclusion

The ascending branch of the lateral femoral circumflex plays a dominant role in the vascularization of the TFL muscle. As a result of a periarticular anastomotic network of the hip, this artery establishes several connections with the proximal arteries. Consequently, in cases where blood flow through the LCFA is interrupted, it should be equally possible to harvest the TFL flap through its accessory vascularization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Agarwal AK, Gupta S, Bhattacharya N, Guha G, Agarwal A (2009) Tensor fascia lata flap reconstruction in groin malignancy. Singap Med J 50(8):781–784

    CAS  Google Scholar 

  2. Bulstrode NW, Kotronakis I, Baldwin MAR (2006) Free tensor fasciae latae musculofasciocutaneous flap in reconstructive surgery: a series of 85 case. J Plast Reconstr Surg 59(2):130–136

    Article  CAS  Google Scholar 

  3. Christopher R, Geddes M, Tang D, Yang SF, Morris (2013) Anatomy of the Integument of the Lower Extremity. In: Perforator Flaps: Anatomy, Technique and Clinical Applications. St. Louis, Missouri p. 667–704

  4. Deiler S, Pfadenhauer A, Widmann J, Stützle H, Kanz KG, Stock W (2000) Tensor Fasciae Latae Perforator flap for reconstruction of composite Achilles tendon defects with skin and vascularized fascia. Plast Reconstr Surg 106(2):342–349

    Article  CAS  PubMed  Google Scholar 

  5. Eburdery H, Chaput B, Andre A, Grolleau JL, Chavoin JP, Lauwers F (2014) Can we consider standard microsurgical anastomosis on the posterior tibial perforator network? An anatomical study. Surg Radiol Anat 36(8):747–753

    Article  PubMed  Google Scholar 

  6. Erçöçen AR, Apaydin I, Emiroğlu M, Yilmaz S, Adanali G, Tekdemir I et al (1998) Island V-Y Tensor Fasciae Latae fasciocutaneous flap for coverage of trochanteric pressure sores. Plast Reconstr Surg 102(5):1524–1531

    Article  PubMed  Google Scholar 

  7. Gosain AK, Yan J-G, Aydin MA, Das DK, Sanger JR (2002) The vascular supply of the extended tensor fasciae latae flap: how far can the skin paddle extend? Plast Reconstr Surg 110(7):1655–1661

  8. Gurunluoglu R (2010) The Ascending Branch of the lateral circumflex femoral vessels: review of the anatomy and its utilization as recipient vessel for Free-Flap Reconstruction of the Hip Region. J Reconstr Microsurgery 26(06):359–366

    Article  Google Scholar 

  9. Hill HL, Nahai F, Vasconez LO (1978) The tensor fascia lata myocutaneous free flap. Plast Reconstr 61(4):517–522

    Article  CAS  Google Scholar 

  10. Isao Koshima, Yamamoto T, Narushima M, Mihara M (2013) Superficial circumflex iliac artery perforator flap. In: Perforator flaps: anatomy, technique and clinical applications. St. Louis, Missouri, pp 551–560

  11. Ishida LH, Munhoz AM, Montag E, Alves HRN, Saito FL, Nakamoto HA et al (2005) Tensor fasciae latae perforator flap: minimizing donor-site morbidity in the treatment of trochanteric pressure sores. Plast Reconstr Surg 116(5):1346–1352

  12. Kalandar A, Morris SF (2019) Three-dimensional vascular anatomical study of the Tensor Fasciae Latae Muscle and perforators. J Reconstr Microsurg 35(6):389–394

    Article  PubMed  Google Scholar 

  13. Karapandic M, Jovanovic M, Stefanovic P, Colic M, Ronevic R, Rasulic L (2004) Anatomic analysis of the vascular network and vascular pedicle of the tensor fascia lata flap (angiographic and cadaver study). Eur J Plast Surg 27(2):61–67

    Article  Google Scholar 

  14. Kawai K, Imanishi N, Nakajima H, Aiso S, Kakibuchi M, Hosokawa K (2004) Vascular anatomy of the Anterolateral Thigh Flap. Plast Reconstr Surg 114(5):1108–1117

    Article  PubMed  Google Scholar 

  15. Kimata Y, Uchiyama K, Ebihara S, Sakuraba M, Iida H, Nakatsuka T et al (2000) Anterolateral Thigh Flap Donor-Site complications and Morbidity. Plast Reconstr Surg 106(3):584–589

    Article  CAS  PubMed  Google Scholar 

  16. Kimata Y, Uchiyama K, Sekido M, Sakuraba M, Iida H, Nakatsuka T et al (1999) Anterolateral thigh flap for abdominal wall reconstruction. Plast Reconstr Surg 103(4):1191–1197

    Article  CAS  PubMed  Google Scholar 

  17. Koshima I, Urushibara K, Inagawa K, Moriguchi T (2001) Free tensor fasciae latae perforator flap for the reconstruction of defects in the extremities. Plast Reconstr Surg 107(7):1759–1765

    Article  CAS  PubMed  Google Scholar 

  18. Lefèvre M, Sarfati B, Honart J-F, Alkashnam H, Rimareix F, Leymarie N et al (2017) Le Lambeau perforant de fascia lata en reconstruction mammaire: une option intéressante en cas de contre-indication Au DIEP. Annal Chir Plast Esth 62(1):97–103

    Article  Google Scholar 

  19. Massoud TF, Fletcher EW (1997) Anatomical variants of the profunda femoris artery: an angiographic study. Surg Radiol Anat 19(2):99–103

    Article  CAS  PubMed  Google Scholar 

  20. Mathes SJ, Buchanan RT (1979) Tensor fascia lata: neurosensory musculo-cutaneous free flap. Br J Plast Surg 32(3):184–187

    Article  CAS  PubMed  Google Scholar 

  21. Mathes SJ, Nahai F (1981) Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 67(2):177–187

    Article  CAS  PubMed  Google Scholar 

  22. Nahai F, Silverton JS, Hill HL, Vasconez LO (1978) The tensor fascia lata musculocutaneous flap. Ann Plast Surg 1(4):372–379

    Article  CAS  PubMed  Google Scholar 

  23. Naohiro K (2013) Lateral Circumflex Femoral Artery– Tensor Fascia Lata Perforator Flap. In: Perforator Flaps: Anatomy, Technique and Clinical Applications. St. Louis, Missouri p. 705 – 16

  24. Pan S-C, Yu J-C, Shieh S-J, Lee J-W, Huang B-M, Chiu H-Y (2004) Distally based Anterolateral Thigh flap: an anatomic and clinical study. Plast Reconstr Surg 114(7):1768–1775

    Article  PubMed  Google Scholar 

  25. Powers JM, Martinez M, Zhang S, Kale SS (2018) A description of the vascular anatomy of the Tensor Fascia Lata Perforator Flap using computed Tomography Angiography. Ann Plast Surg 80:S421–S425

    Article  CAS  PubMed  Google Scholar 

  26. Saadeh FA, Haikal FA, Abdel-Hamid FAM (1998) Blood supply of the tensor fasciae latae muscle. Clin Anat 11(4):236–238

    Article  CAS  PubMed  Google Scholar 

  27. Stevenson TR, Nahai F (2015) Tensor Fasciae Latae Musculocutaneous Flap. In: Grabb’s Encyclopedia of Flaps_ Upper Extremities, Torso, Pelvis, and Lower Extremities p. 1316-9

  28. Totlis T, Paparoidamis G, Terzidis I, Piagkou M, Tsiridis E, Natsis K (2020) Surgical anatomy of the lateral circumflex femoral artery branches: contribution to the blood loss control during hip arthroplasty. Ann Anat 232:151566

    Article  CAS  PubMed  Google Scholar 

  29. Wangensteen OH (1934) Repair of recurrent and difficult hernias and other large defects of the abdominal wall employing the iliotibial tract of fascia lata as a pedicles flap. Surg Gynecol Obstet 59:766–780

    Google Scholar 

Download references

Funding

The authors have no funding to disclose.

Author information

Authors and Affiliations

  1. Plastic and Reconstructive Surgery Department, Rangueil University Hospital Center of Toulouse, 1 Avenue du Professeur Jean Poulhès, Toulouse, 31400, France

    Silvia Gandolfi & B Chaput

  2. Plastic and Reconstructive Surgery Department, Pontchaillou University Hospital Center of Rennes, 2 Rue Henri le Guilloux, Rennes, 35000, France

    Y Berkane

  3. Plastic and Reconstructive Surgery Department, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d’Azur, Nice, France

    E Lupon

  4. Plastic Surgery Department, Habib Bourguiba University Hospital Sfax, Sfax, Tunisia

    A Karra

Authors
  1. Silvia Gandolfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B Chaput
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y Berkane
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Lupon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Karra
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SG: Manuscript writing and Project development BC: Project development YB, EL: Manuscript writing AK: Data collection and project development All authors reviewed the manuscript.

Corresponding author

Correspondence to Silvia Gandolfi.

Ethics declarations

Ethical approval

Subjects gave their informed consent for inclusion before participating in the study. The study was conducted in accordance with the Declaration of Helsinki.

Competing interests

The authors have no financial or non-financial interests to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gandolfi, S., Chaput, B., Berkane, Y. et al. The accessory vascularization of the tensor fasciae latae muscle: towards a new classification?. Surg Radiol Anat 46, 725–731 (2024). https://doi.org/10.1007/s00276-024-03343-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-024-03343-8

Keywords

Search

Navigation