[The lateral crural flap nourished by cutaneous branches of peroneal artery: an anatomic and clinical study].
OBJECTIVE
To study the anatomy of lateral crural skin flap nourished by cutaneous branches of peroneal artery and its clinical application as vascularized skin flap transfer.


METHODS
In 20 cadavers specimen with 40 lower limbs, the cutaneous branches of the peroneal artery were dissected and their measurements were recorded. In the other 30 adult legs, their perforating points of the cutaneous arteries of peroneal artery were detected with supersonic Doppler flow meter. With the aid of anatomic and supersonic Doppler flow meter study, vascularized transfer of lateral crural skin flap pedicled by cutaneous branches of peroneal artery were successfully performed in 21 clinical cases.


RESULTS
In altogether 40 legs studied, 140 cutaneous branches were found. One to seven branches were found on one specimen, the average was 3.5 branches, in one leg was a high perforating skin branch. The perforating points of the cutaneous branches were mostly (76% cases) appeared within 7 - 21 cm length below the protruding point of head of fibula. The external diameter of the thickest cutaneous branch of each leg was (1 .4 - 2.9) mm, (1.8 +/- 0.4) mm, while the external diameters of two vena concomitants were (3.0 +/- 0.5) mm and (2.4 +/- 0.4) mm. 145 artery perforating points in 30 legs were detected by Doppler, with an average points of 4.8. The skin flaps taken in the 21 clinical cases were 5.0 cm x 3.5 cm - 28 cm x 11 cm in size. All the transferred free flaps survived uneventfully.


CONCLUSIONS
The lateral crural skin flap is nourished by a variable number of cutaneous branches of peroneal artery. The main branch can meet the demand of microvascular anastomosis. The free transfer of lateral crural flap by anastomosis of cutaneous branch of peroneal artery is superior to lateral skin flap transfer by anastomosis of main trunk of peroneal artery with the merit of simple procedure, minimal trauma and more physiological circulation established.
Song
Xiu-Ju
XJ
Department of Orthopaedics, Qingdao Municipal Hospital, Qingdao University Medical School, Qingdao 266011, China. songxiujun@hotmail.com
Shao
Xu-Jian
XJ
Qu
Yong-Ming
YM
Zhou
Xiang
X
Wang
Tao
T
Xu
Guo-Shi
GS
D000328:Adult; D000368:Aged; D001158:Arteries / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D012867:Skin / Q000033:anatomy & histology* / Q000098:blood supply*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D055815:Young Adult