title: Anatomical study and clinical applications of free posterior tibial flap in the head and neck region.
abstract: BACKGROUND
  The purpose of this study was to examine the anatomical features, clinical applications, and donor-site morbidities of the free posterior tibial flap.
  
  
  METHODS
  The posterior tibial vascular system was examined in 30 fresh cadaver legs. This was followed by a clinical study involving patients with free posterior tibial flap reconstruction of defects in the head and neck region after tumor extirpation. Potential donor-site morbidities were studied at 1 year after surgery.
  
  
  RESULTS
  The mean caliber of the posterior tibial artery and the venae comitantes in the cadaveric limbs was 2.7, 2.9, and 2.17 mm, respectively. The mean number of septocutaneous perforators was 2.85 per leg, clustering in the middle and distal thirds of the medial surface of the leg. The mean thickness of the skin and subcutaneous fat in the region was 4.43 mm. In the clinical study, 64 patients with superficial cutaneous and mucosal defects were recruited. The majority of the patients had carcinoma of the oral cavity. All flaps survived. Three patients (4.7 percent) developed mild infection of the donor site. None of the patients have problems walking on level ground. There was no significant reduction in range of ankle movement, nor was there evidence of vascular compromise of the lower limb, either at rest or after exercise.
  
  
  CONCLUSIONS
  The free posterior tibial flap is reliable because of its constant vascular anatomy. It is thin and pliable, making it particularly suitable for resurfacing superficial cutaneous and mucosal defects. Although skin grafting is required to repair the donor site, the associated morbidity is low.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Hong Kong SAR, China From the Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital.
authors.forename: Yu Wai
authors.initials: YW
authors.lastname: Chan
authors.forename: Raymond Wai Man
authors.initials: RWM
authors.lastname: Ng
authors.forename: William Ignace
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D010039:Otorhinolaryngologic Neoplasms / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply*; D011795:Surveys and Questionnaires; D016909:Tibial Arteries / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014034:Toes / Q000098:blood supply; D018615:Ultrasonography, Doppler, Color