ObjectiveTo investigate the feasibility of the anterolateral thigh free flap with the oblique branch in reconstructing the soft tissue defects of lower extremity. MethodsBetween June 2009 and February 2013,12 patients (including 7 males and 5 females) with soft tissue defects of lower extremity were treated with the anterolateral thigh free flap with the oblique branch,aged from 8 to 42 years (median,32 years).The locations of soft tissue defect were the dorsum of the foot in 5 cases,the ankle and foot in 4 cases,the lower leg in 2 cases,and the distal foot in 1 case.All defects were associated with exposure of tendon and bone.The size of the wound was from 15 cm×7 cm to 27 cm×12 cm.The interval of injury and operation was 1 to 7 days (mean,3.7 days).The anterolateral thigh flap was pedicled with only the oblique branch in 7 patients,and with the both descending branch and oblique branch in 5 patients,and the size of flap was from 17 cm×9 cm to 30 cm×15 cm.The donor sites were repaired by suture in 3 patients,and by skin graft in 9 patients. ResultsDistal skin flap necrosis occurred in 1 case,and was cured after dressing change and skin graft.The other flaps survived,and the donor site healed primarily.The follow-up time was from 10 months to 2 years (mean,18 months).Thinning operation was performed in 3 cases,and the other flaps recovered pain and warm sensation with good appearance. ConclusionIt is a safe and effective method to reconstruct soft tissue defects of the lower extremity with the anterolateral thigh flap pedicled with the oblique branch.