Piral T, Germain M, Princ G, Dubousset J
Service de Chirurgie Maxillo-Faciale et Stomatologie, Centre Hospitalier Lagny Marne-la-Vallée, Lagny-sur-Marine, France.
Ann Chir Plast Esthet. 1997 Dec;42(6):629-34.
The authors report two well documented cases of absent posterior tibial artery in patients undergoing free fibula transplant. The first patient was a 50-year-old woman treated by pelvimandibulectomy for squamous cell carcinoma, leaving a defect of the floor of the mouth. The second case was an 11-year-old child with Ewing sarcoma of the femoral metaphysis, in whom femoral reconstruction was performed by vascularized free fibula transplant. Based on these two cases, the authors describe their diagnostic and therapeutic approach designed to avoid risks associated with this anatomical variant. Absence of the posterior tibial artery can be confirmed by arteriography and duplex ultrasound. The authors propose duplex ultrasound as first-line investigation as this safe, noninvasive examination provides sufficient information in the majority of cases at a lower cost. In parallel, the various anatomical variants affecting the origin of leg arteries from the popliteal artery are classified into seven groups based on a phylogenetic and embryological study.
作者报告了两例在接受游离腓骨移植的患者中记录良好的胫后动脉缺如病例。第一例患者是一名50岁女性，因鳞状细胞癌接受骨盆下颌骨切除术，导致口腔底部缺损。第二例是一名11岁患有股骨近端尤文肉瘤的儿童，通过带血管蒂的游离腓骨移植进行股骨重建。基于这两例病例，作者描述了他们旨在避免与这种解剖变异相关风险的诊断和治疗方法。胫后动脉缺如可通过动脉造影和双功超声来确诊。作者建议将双功超声作为一线检查方法，因为这种安全、无创的检查在大多数情况下以较低成本就能提供足够的信息。同时，根据系统发育和胚胎学研究，将影响腘动脉发出小腿动脉的各种解剖变异分为七组。
