Department of Plastic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Department of Radiology, Hull University Teaching Hospitals NHS Trust, Hull, UK.
J Med Case Rep. 2021 Dec 13;15(1):601. doi: 10.1186/s13256-021-03133-5.
Complex orthoplastic lower limb trauma in individuals with multiple injuries requires considerable resources and interdisciplinary collaboration for good outcomes. We present the first reported end-to-side free flap microanastomosis for lower limb trauma reconstruction involving a peronea arteria magna without radiographic collaterals.
A 55-year-old Caucasian gentleman involved in road traffic collision sustained an open tibial fracture on the anteromedial distal third of the left lower leg with local degloving and a subtotal right foot and ankle degloving. Both injuries were reconstructed with free tissue transfer. A left lower limb peronea arteria magna successfully received a free gracilis muscle flap by end-to-side microanastomosis and perfusion of the foot was preserved. This rare anatomical variant and its anatomy is reviewed, as well as a description of the suggested preoperative planning and technique for reconstruction.
Successful free flap reconstruction may be performed to a lower limb with a peronea arteria magna recipient as the lone vessel supplying the foot in trauma, although preoperative counseling of the risks, benefits, and options are essential.
Level V, case report.
多发伤患者的复杂矫形下肢创伤需要大量资源和多学科协作才能取得良好的效果。我们报告首例涉及无影像学侧支的巨大腓动脉的下肢创伤重建的端端吻合游离皮瓣微血管吻合术。
一名 55 岁的白人男性，在道路交通事故中受伤，左小腿前内侧远端三分之一处发生开放性胫骨骨折，伴有局部撕脱伤和右足及踝关节部分撕脱伤。两处损伤均采用游离组织转移进行重建。左下肢巨大腓动脉成功接受游离股薄肌皮瓣端端吻合术，足部血供得以保留。本文回顾了这种罕见的解剖变异及其解剖结构，并描述了建议的术前规划和重建技术。
尽管术前需要对风险、益处和选择进行咨询，但对于创伤中唯一供应足部的腓动脉受区肢体，游离皮瓣重建仍可成功进行。
V 级，病例报告。
