Transplantation of the proximal fibula based on the anterior tibial artery. Anatomical study and clinical application.
The purpose of this study was to investigate the feasibility of microvascular transplantation, based on the anterior tibial artery, of the epiphysis and the proximal half of the diaphysis of the fibula. India ink injections into the anterior tibial artery were performed in 13 unembalmed adult cadavers, following which transverse frozen sections were taken. Dye was observed in the fibula, both within the intramedullary cavity and at the level of the periosteum, in all specimens. The average distal limit reached by the dye, measured from the tip of the epiphysis, was 10.4 cm in the intramedullary cavity and 11.8 cm in the periosteum. Based on these anatomical findings one case of humeral reconstruction has been performed with a fibular transplant, including both the epiphysis and a segment of diaphysis, vascularized solely by the anterior tibial artery.
Service de Chirurgie Orthopédique Infantile, Hôpital d'Enfants, Allée du Morvan, F-54511 Vandoeuvre-les-Nancy cedex, France.
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MC
Menezes-Leite
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G
Dautel
F
F
Duteille
P
P
Lascombes
D000328:Adult; D002102:Cadaver; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D016909:Tibial Arteries / Q000033:anatomy & histology*