Zhang G M, Syed S A, Tsai T M
Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, KY 40202, USA.
Microsurgery. 1995;16(3):144-8. doi: 10.1002/micr.1920160306.
A new axial skin flap based on the middle cutaneous branch of the medial plantar artery was evaluated in 33 fresh cadaver legs. The vascular pedicle of the skin flap is based on the middle cutaneous artery, its venae comitantes, and segments of the great saphenous vein, if necessary. The middle cutaneous artery is the largest cutaneous branch, arising from the medial plantar artery 2.5 cm distal to its origin. The diameter of its origin is 1.2 mm, and its pedicle is 2 cm long. The midline of the flap runs from the first web space to the heel tip. The upper and lower borders of the flap are 3 to 4 cm on either side of this line. The upper border is medial to the extensor hallucis tendon, and the lower border is medial to the abductor hallucis. Distally, the border begins 2 cm proximal to the metatarsalphalangeal joint; proximally, the border is at the middle of the medial malleolus. The flap diameter can be up to 8 x 12 cm. The middle cutaneous branch of the medial plantar artery was found in all cadaver specimens, except for one with a common trunk. The new flap design leaves the major blood supply to the foot and the plantar aponeurosis intact. It is easy to harvest and may be used either as an island flap or free flap.
在33条新鲜尸体下肢上评估了一种基于足底内侧动脉中间皮支的新型轴型皮瓣。皮瓣的血管蒂基于中间皮动脉、其伴行静脉，必要时还包括大隐静脉的节段。中间皮动脉是最大的皮支，在其起源点远侧2.5 cm处起自足底内侧动脉。其起始处直径为1.2 mm，蒂长2 cm。皮瓣的中线从第一趾蹼间隙延伸至足跟尖。皮瓣的上、下边界在该线两侧各3至4 cm。上边界在拇长伸肌腱内侧，下边界在拇展肌内侧。在远端，边界始于跖趾关节近端2 cm处；在近端，边界位于内踝中部。皮瓣直径可达8×12 cm。除1例为共同主干外，在所有尸体标本中均发现了足底内侧动脉的中间皮支。新的皮瓣设计使足部和足底腱膜的主要血供保持完整。它易于切取，可作为岛状皮瓣或游离皮瓣使用。
