The distal fibular perforating axial flap for lateral malleolus coverage: an anatomical description and surgical technique.

IF 1.2 4区医学 Q3 ANATOMY & MORPHOLOGY

Surgical and Radiologic Anatomy Pub Date : 2023-10-01 Epub Date: 2023-08-08 DOI:10.1007/s00276-023-03204-w

Philippe Clavert, Benjamin Puliero, David Eichler, Irène Ollivier, François Bonnomet

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引用次数: 0

Abstract

Purpose: Skin closure disorders in ankle surgery are a recurrent problem not only in traumatology but also in elective surgery. The aim of the study was to describe the anatomical basis of the fasciocutaneous vascularization of the lateral malleolus region to develop a posterior cover flap for the region.

Methods: We dissected ten fresh frozen specimens after arterial injection of an Indian ink preparation and individualized the perforating arteries. Their positions and diameters were collated. Then, the surgical technique was clinically applied for two different cases by transferring the fasciocutaneous flap posterior to the lateral malleolus to cover a loss of skin substance.

Results: There were in average 5 fibular perforators over the last 100 mm of the fibula. The average diameter of the first two perforating arteries was 0.6 ± 0.12 mm and 0.9 ± 0.25 mm, respectively, and the consistency of the latter makes it possible to produce a skin flap with anterior translation. This is an axial flap. Two patients were operated on using this technique. There was no necrosis of the posterior fibular flap and healing was achieved by the third post-operative week.

Conclusion: This study showed the presence of fibular perforating arteries with a high reproducibility of their dissection. This anatomical description served as the basis for the description of a new distal fibular perforating flap.

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用于外踝覆盖的腓骨远端穿孔轴状皮瓣：解剖学描述和手术技术。

目的：踝关节手术中的皮肤闭合障碍是一个反复出现的问题，不仅在创伤科，在选择性手术中也是如此。本研究的目的是描述外踝区筋膜皮血管形成的解剖学基础，以开发该区域的后皮瓣。方法：我们在动脉注射印度墨水制剂后解剖了10个新鲜冷冻标本，并对穿通动脉进行了个体化。对它们的位置和直径进行了核对。然后，该手术技术在临床上应用于两个不同的病例，将筋膜皮瓣转移到外踝后部，以覆盖皮肤物质的损失。结果：腓骨最后100 mm平均有5个腓骨穿支。前两条穿通动脉的平均直径为0.6 ± 0.12毫米和0.9 ± 0.25mm，而后者的一致性使得可以产生具有向前平移的皮瓣。这是一个轴向襟翼。两名患者使用该技术进行了手术。腓骨后皮瓣没有坏死，术后第三周愈合。结论：本研究显示腓骨穿通动脉的存在，其解剖具有较高的可重复性。这一解剖学描述为描述一种新的腓骨远端穿通皮瓣奠定了基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy ANATOMY & MORPHOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.70

自引率

14.30%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.