From the Departments of Orthopedic Surgery and Hand Surgery, Nara Medical University; the Department of Orthopedic Surgery, Chiangmai Medical University; and the Department of Anatomy, Faculty of Medicine, and the Excellence of Osteology Research and Training Center, Chiangmai University.
Plast Reconstr Surg. 2018 Aug;142(2):548-551. doi: 10.1097/PRS.0000000000004585.
There is lack of anatomical information regarding the cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. The authors aimed to evaluate the anatomical basis of the popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate their experience using this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery. The authors investigated the number, location, length, and diameter of cutaneous perforators of the popliteal artery. Based on the results, the authors treated three cases with a large soft-tissue defect around the knee using a popliteal artery perforator-based propeller flap. The authors found a mean of 1.9 cutaneous perforators arising from the popliteal artery, with a mean pedicle length of 6 cm and a mean arterial internal diameter of 0.9 mm, which were located at an average of 4 cm proximal to the bicondylar line. The most distal perforator consistently arose along the small saphenous vein and connected proximally with the concomitant artery of the posterior femoral cutaneous nerve, forming a connection with perforating arteries of the profunda femoris artery. A mean of 4.5 cutaneous perforators branched from the arterial connection sites. All clinical cases healed without any complications. The popliteal artery perforator-based propeller flap is reliable for reconstruction of soft-tissue defects around the knee. The flap should include the deep fascia and concomitant artery along with the posterior femoral cutaneous nerve for maintaining the blood supply.
关于腘动脉皮穿支及其与臀下动脉和股深动脉降支的连接，解剖学信息较为缺乏。作者旨在评估基于后大腿区域的腘动脉穿支推进皮瓣的解剖学基础，并展示他们使用该皮瓣的经验。在将硅酮化合物注入股动脉后，解剖了 10 个新鲜的下肢尸体标本。作者研究了腘动脉皮穿支的数量、位置、长度和直径。根据结果，作者使用腘动脉穿支推进皮瓣治疗了 3 例膝关节周围大软组织缺损的患者。作者发现，从腘动脉发出的皮穿支平均为 1.9 个，蒂长平均为 6cm，动脉内直径平均为 0.9mm，位于双髁线近端 4cm 处。最远端的穿支始终沿着小隐静脉出现，并与股后皮神经的伴行动脉近端相连，与股深动脉的穿支动脉形成连接。平均有 4.5 个皮穿支从动脉连接部位分出。所有临床病例均愈合良好，无任何并发症。基于腘动脉穿支的推进皮瓣是重建膝关节周围软组织缺损的可靠方法。皮瓣应包括深筋膜和伴行动脉以及股后皮神经，以维持血液供应。
