[Free fibula transplant and practical approach in the absence of posterior tibial artery. A report of 2 cases].
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.
Service de Chirurgie Maxillo-Faciale et Stomatologie, Centre Hospitalier Lagny Marne-la-Vallée, Lagny-sur-Marine, France.
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T
Piral
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M
Germain
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G
Princ
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J
Dubousset
D001859:Bone Neoplasms / Q000601:surgery; D002648:Child; D005260:Female; D005263:Femoral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D005269:Femur / Q000601:surgery*; D005360:Fibula / Q000000981:diagnostic imaging / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012512:Sarcoma, Ewing / Q000601:surgery; D016909:Tibial Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color
Transplant libre de péroné et attitudes pratiques en cas d'absence d'artère tibiale postérieure. A propos de deux cas.