Evaluation of the vessels of the lower leg before microsurgical fibular transfer. Part I: anatomical variations in the arteries of the lower leg
Evaluation of the vessels of the lower leg before microsurgical fibular transfer. Part I: anatomical variations in the arteries of the lower leg
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DOI：
10.1016/j.bjoms.2010.05.002
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发表时间：
2011-06-01
影响因子：
1.8
通讯作者：
Kesting, Marco Rainer
中科院分区：
文献类型：
--
作者：
Hoelzle, Frank;Ristow, Oliver;Kesting, Marco Rainer
腓骨皮瓣的灌注是基于腓动脉。为避免动脉切除后小腿缺血，术前必须保证充分的灌注。尽管常见的解剖变异和病理变化已得到广泛认可，但术前评估血管系统的最佳方法仍存在争议。我们的目的是确定解剖血管模式，可能危及肢体或皮瓣，而腓骨被收获，并提供一些简单的规则，术前评估技术的评估。我们解剖了128条保存在福尔马林中的小腿，并评估了血管解剖变异的发生率。此外，我们还测量了绝对和相对体积损失。腓动脉的容量损失相当大，损失23%。有两次腓动脉与胫前动脉在足背处的足背动脉吻合;有四次胫动脉直接从腓动脉发出;有五次只发现了一个残留的胫后动脉。小腿有许多血管变异，其中一些可能会使皮瓣或肢体处于危险之中。因此，我们认为术前评估血管系统是可取的。(C)2010年英国口腔颌面外科医师协会。由爱思唯尔有限公司出版。保留所有权利。
Perfusion of a fibular flap is based on the peroneal artery. To avoid ischaemia of the lower leg postoperatively after the artery has been sacrificed, adequate perfusion must be guaranteed preoperatively. Although common anatomical variations and pathological changes are well recognised, the best way to evaluate the vascular system preoperatively is controversial. Our aim was to identify anatomical vascular patterns that may jeopardise either the limb or the flap while the fibula is being harvested, and provide a few simple rules for the assessment of preoperative evaluation techniques. We dissected 128 lower legs preserved in formalin and evaluated them for the incidence of vascular anatomical variants. In addition we measured absolute and relative loss of volume. Volume loss from the peroneal artery was considerable, with a loss of 23%. On two occasions the peroneal artery mimicked the anterior tibial artery in its course to the dorsalis pedis artery at the dorsum of foot; four times the tibial artery arose directly from the peroneal artery; and five times only a rudimentary posterior tibial artery could be found. There are numerous vascular variants in the lower leg, some of which could put the flap or the limb at risk. We therefore think that preoperative evaluation of the vascular system is advisable. (C) 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.