[Anatomic study and clinical application of thinned posterior tibial artery perforator flap].
OBJECTIVE
To explore the feasibility and therapeutic effect of thinned posterior tibial artery free perforator flap for the reconstruction of soft tissue defects at dorsum of hands.


METHODS
Six fresh adult lower limbs specimens were injected with red latex via arterial cannula and dissected. The number, distribution, branches, and outer diameter of posterior tibia artery perforators were observed. Based on the anatomic study, the perforator flaps were designed to reconstruct soft tissue defects at dorsum of hands and wrists. The redundant fat on the flaps was removed, but preserving the nutrient vascular system. 11 flaps were used with the size ranging from 2 cm x 5 cm to 10 cm x 14 cm.


RESULTS
43 skin perforators of posterior tibial artery were observed in six lower limbs, 29 perforators with the outer diameter is greater than 0.5 mm when they threading over the deep fascia plane, on average every 4.8 bundles of sides. The mean outside diameter of perforating artery is (1.8 +/- 0.5) mm, and the length is (44 +/- 15) mm. 6 perforators were founded both in the second and fifth zone which could be used for anastomosis for its better diameters. All flaps survived completely without any complication at donor sites. 7 cases were followed up for 3-12 months. Both satisfactory functional and cosmetic results were achieved with a soft and thinned appearance.


CONCLUSIONS
The thinned posterior tibial artery free perforator flap has a reliable blood supply and good appearance. It is very suitable for the reconstruction of small or medium-sized defects at the dorsum of hands and wrists.
Department of Plastic Surgery, Third People Hospital of Jinan, Jinan 250101, China.
Feng-Lin
FL
Zhao
Zong-Bao
ZB
Li
Xin
X
Wang
Hui-Feng
HF
Han
Chang-De
CD
Wang
Liang
L
Hu
D000293:Adolescent; D000328:Adult; D005260:Female; D006230:Hand Injuries / Q000601:surgery; D006801:Humans; D035002:Lower Extremity / Q000033:anatomy & histology / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods; D016909:Tibial Arteries / Q000033:anatomy & histology* / Q000637:transplantation*; D055815:Young Adult