This paper is only available as a PDF. To read, Please Download here.
The vascular anatomy of the posterior tibial vessels has been studied in 20 legs of 10 cadavers. The number, size and distribution of the direct cutaneous and direct muscle branches of the posterior tibial vessels were recorded. For analysis, the leg was divided into four equal segments, Zone I being the most distal and Zone IV the most proximal. The direct cutaneous branches were found to cluster mainly around Zone II. The direct muscle branches to the soleus and flexor digitorum longus muscles arose chiefly in Zones II and III. Based on this knowledge, we performed fasciocutaneous, island soleus muscle, musculo-fasciocutaneous and flexor digitorum longus muscle flaps based on the posterior tibial vessels in 12 patients. Four were free fasciocutaneous flaps and eight were pedicled flaps. All flaps survived and there were no major complications. Delayed wound healing was encountered in three patients.
- Reconstruction of the lower leg and foot with the reverse pedicled posterior tibial fasciocutaneous flap.Br J Plast Surg. 1989; 42: 512-516
- Heel and foot reconstruction using reverse-flow posterior tibial flap.Ann Plast Surg. 1990; 24: 318-327
- The reverse-flow posterior tibial artery island flap: anatomic study and 72 clinical cases.Plast Reconstr Surg. 1990; 86: 312-318
- An anatomic study of the septocutaneous vessels of the leg.Plast Reconstr Surg. 1985; 76: 354-363
- Anatomy of the human body.in: 30th American ed. Lea & Febiger, Philadelphia1985: 577
- The Doppler probe for planning flaps: anatomical study and clinical applications.Br J Plast Surg. 1990; 43: 1-16
- The vascular territories (angiosomes) of the body: experimental study and clinical applications.Br J Plast Surg. 1987; 40: 113-141
- Ikeda A. The vasculature and clinical application of the posterior tibial perforator-based flap.Plast Reconstr Surg. 1992; 90: 643-649
- Hemisoleus and reversed hemisoleus flaps.Plast Reconstr Surg. 1985; 76: 87-96
- Clinical atlas of muscle and musculocutaneous flaps.in: The CV Mosby Company, St. Louis1979: 179-187
- The dorsalis pedis arterialized flap. A clinical study.Plast Reconstr Surg. 1975; 55: 177-185
- Reconstruction of the lower leg and foot with the reverse-pedicled anterior tibial flap: preliminary report of a new fasciocutaneous flap.Br J Plast Surg. 1986; 39: 327-337
- Peroneal island flap for skin defects in the lower extremity.J Bone Joint Surg. 1985; 67A: 935-941
- Reconstruction of the heel pad by flexor digitorum brevis musculocutaneous flap transfer.Plast Reconstr Surg. 1984; 74: 86-96
- The distally based posterior tibial arterial adipofascial flap.Br J Plast Surg. 1992; 45: 284-287
- The reversed fasciosubeutaneous flap in the leg.Plast Reconstr Surg. 1991; 88: 1034-1043
- Use of a pedicled fascial flap based on septocutaneous perforators of the posterior tibial artery for repair of distal lower limb defects.Br J Plast Surg. 1992; 45: 141-145
- Heel coverage with a deepithelialized distally based fasciocutaneous flap.Plast Reconstr Surg. 1990; 85: 116-119
Accepted: February 18, 1993
Received: November 18, 1992
© 1993 The British Association of Plastic Surgeons. Published by Elsevier Inc.