Angiosomes of the foot and ankle and clinical implications for limb salvage: Reconstruction, incisions, and revascularization
Angiosomes of the foot and ankle and clinical implications for limb salvage: Reconstruction, incisions, and revascularization
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DOI：
10.1097/01.prs.0000222582.84385.54
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发表时间：
2006-06-01
影响因子：
3.6
通讯作者：
Cooper, P
中科院分区：
文献类型：
--
作者：
Attinger, CE;Evans, KK;Cooper, P
背景：伊恩·泰勒引入了血管体概念，将身体分成由源动脉供血的不同三维组织块。了解血管体的足和踝关节和它们的源动脉之间的相互作用是临床上有用的外科手术的足和踝关节，特别是在周围vascular diseases.Methods的存在：在50具尸体解剖的下肢，动脉注射不同颜色的甲基丙烯酸甲酯和解剖。术前，每个重建患者的血管解剖结构进行了常规分析，使用多普勒仪器和结果进行evaluated.Results：有六个血管球的足部和踝关节起源于三个主要动脉及其分支的足部和踝关节。胫后动脉的三个分支各自供应足底足的不同部分。腓动脉的两个分支供应踝部和后足的前外侧部分。胫前动脉供应前踝，其延续足背动脉供应足背。血液流向足部和踝关节是多余的，因为供给足部的三条主要动脉有多个动脉-动脉连接。通过选择性地对这些连接进行多普勒检查，可以快速绘制现有血管树和血流方向。结论：足部和踝关节血管解剖的详细知识使整形外科医生能够计划血管健全的重建，足部和踝关节外科医生能够设计底层骨骼的安全暴露，以及血管外科医生为给定伤口选择最有效的血管重建。
Background: Ian Taylor introduced the angiosome concept, separating the body into distinct three-dimensional blocks of tissue fed by source arteries. Understanding the angiosomes of the foot and ankle and the interaction among their source arteries is clinically useful in surgery of the foot and ankle, especially in the presence of peripheral vascular disease.Methods: In 50 cadaver dissections of the lower extremity, arteries were injected with methyl methacrylate in different colors and dissected. Preoperatively, each reconstructive patient's vascular anatomy was routinely analyzed using a Doppler instrument and the results were evaluated.Results: There are six angiosomes of the foot and ankle originating from the three main arteries and their branches to the foot and ankle. The three branches of the posterior tibial artery each supply distinct portions of the plantar foot. The two branches of the peroneal artery supply the anterolateral portion of the ankle and rear foot. The anterior tibial artery supplies the anterior ankle, and its continuation, the dorsalis pedis artery, supplies the dorsum of the foot. Blood flow to the foot and ankle is redundant, because the three major arteries feeding the foot have multiple arterial-arterial connections. By selectively performing a Doppler examination of these connections, it is possible to quickly map the existing vascular tree and the direction of flow.Conclusions: Detailed knowledge of the vascular anatomy of the foot and ankle allows the plastic surgeon to plan vascularly sound reconstructions, the foot and ankle surgeon to design safe exposures of the underlying skeleton, and the vascular surgeon to choose the most effective revascularization for a given wound.