Faculty Collaboration Database

The anterior tibial artery flap: anatomic study and clinical application. Plast Reconstr Surg 1987 Mar;79(3):396-406

Date

03/01/1987

Pubmed ID

3823215

DOI

10.1097/00006534-198703000-00014

Scopus ID

2-s2.0-84932371792 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Satisfactory replacement of skin defects over the lower leg remains a difficult problem. Various forms of coverage, including, local rotation flaps, muscle flaps, and fascial and free flaps, have their specific indications and inherent disadvantages. In this work, a new axial skin flap based on perforating vessels in the territory of the anterior tibial artery is described. A series of 50 lower leg dissections was carried out in 25 fresh cadavers after latex injection into the femoral artery. Detailed studies of the cutaneous distribution of the anterior tibial artery showed that three main arteries perfuse the anterior lateral portion of the lower leg. The superior lateral peroneal artery and the inferior lateral peroneal artery interseptal cutaneous perforators arise at an average of 25.6 and 17.2 cm from the lateral malleolus, respectively. The superior lateral peroneal artery was present in 100 percent of the specimens, whereas the inferior lateral peroneal artery was present in 70 percent of the specimens. In their course, they give several muscular branches to the peroneus longus and brevis prior to perforating the fascia and arborizing in the subcutaneous tissues of the anterolateral portion of the leg. The average external diameter was 1.6 cm for the superior and 1.4 cm for the inferior lateral peroneal artery. The superficial peroneal nerve accessory artery is the third artery which contributes to the skin of the lower leg. It arises from the superior lateral peroneal artery in 30 percent of cases, from the inferior lateral peroneal artery in 40 percent, and from both in 30 percent. The artery runs along with the superficial peroneal nerve and gives several cutaneous perforators along its descending course. Several cutaneous axial flaps can be fashioned around this anatomy. The operative technique along with demonstrative clinical cases is presented followed by pertinent discussion.

Author List

Recalde Rocha JF, Gilbert A, Masquelet A, Yousif NJ, Sanger JR, Matloub HS

Authors

Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Arteries
Cadaver
Child
Humans
Leg Ulcer
Male
Middle Aged
Peroneal Nerve
Skin
Surgical Flaps
Tibia