Institute of Normal Anatomy, Medical School, 4, rue Kirschleger, 67085, Strasbourg Cedex, France.
Department of Orthopedic, University Hospital Hautepierre 2, Strasbourg, France.
Surg Radiol Anat. 2023 Oct;45(10):1191-1196. doi: 10.1007/s00276-023-03204-w. Epub 2023 Aug 8.
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.
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.
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.
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.
踝关节手术中的皮肤闭合障碍不仅是创伤学中的一个常见问题，也是选择性手术中的一个常见问题。本研究旨在描述外踝区域的筋膜皮血管解剖基础，以开发该区域的后覆盖皮瓣。
我们对十个经过动脉注射印度墨水制剂的新鲜冷冻标本进行了解剖，并对穿支动脉进行了个体化。记录了它们的位置和直径。然后，通过将皮瓣从外踝后方转移到皮瓣，以覆盖皮肤物质的损失，将该手术技术应用于两种不同的病例。
在腓骨的最后 100mm 处，平均有 5 个腓骨穿支。前两个穿支动脉的平均直径分别为 0.6±0.12mm 和 0.9±0.25mm，后者的一致性使得能够产生具有前向平移的皮瓣。这是一种轴形皮瓣。两名患者均采用该技术进行手术。腓骨后皮瓣无坏死，第三周愈合。
本研究表明存在腓骨穿支动脉，其解剖分离具有高度可重复性。该解剖描述为描述新的远端腓骨穿支皮瓣提供了基础。
