Posterior Tibial Artery Perforator Flap: An Anatomical Study and Clinical Applications.

Lee, Sang Yun; Yang, Jung Dug; Kim, Il Whan; Jung, Ho Yun; Cho, Byung Chae; Park, Jae Woo

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(5):562-568.
Published online September 1, 2007.

Posterior Tibial Artery Perforator Flap: An Anatomical Study and Clinical Applications.

Sang Yun Lee, Jung Dug Yang, Il Whan Kim, Ho Yun Jung, Byung Chae Cho, Jae Woo Park

¹Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook National University, Daegu, Korea. lambyang@paran.com
²S Jelim Plastic Surgery Center, Seoul, Korea.

Abstract

PURPOSE
Many studies reported anatomy of posterior tibial artery perforator. But, it is not easy to use this flap in clinical case. METHODS: Authors performed cadaver dissection on 26 legs from 13 cadavers and identified the number, location, type, length and diameter of perforator. Based on anatomic study, posterior tibial artery perforator flap was performed on 3 clinical cases.
RESULTS
The perforator was found on a line drawn from the medial boarder of central patella to posterior boarder of medial malleolus. The main perforator which was longer and greater caliber than others was found was found 13 to 17cm distant from medial boarder of central patella in 23 of 26 leg(88.5%). Average length was 6.2cm and average diameter was 1.4mm. The main perforator was musculocutaneous perforator at 20 of 26 leg(77%). The posterior tibial artery perforator flap was clinically use in 3 cases. All flap were survived without any complication.
CONCLUSION
The author found the main perforator of posterior tibial artery perforator flap was located 15cm distant from medial boarder of central patella within the circle drawn with a radius of 4cm. The posterior tibial artery perforator flap is expected to be used as one of the option for the reconstruction of hand and foot.

Keywords: Posterior tibial artery; Free flap