title: Anatomical basis of the reverse lateral plantar artery perforator flap design.
abstract: BACKGROUND
  This study aims to explore the characteristics of the formation and topography of lateral plantar artery perforators to identify a repair procedure for defects in the forefoot region.
  
  
  METHODS
  Thirty-three cadavers were available for this anatomical study. The tuberosity of the fifth metatarsal bone was adopted as the anatomical landmark. The details of the lateral plantar artery perforators and the anastomosis between the lateral plantar artery perforators and other arteries of lateral foot were recorded.
  
  
  RESULTS
  The perforators from the base and head of the fifth metatarsal bone constantly originate from the lateral plantar artery in the area of tuberosity of the fifth metatarsal, run along the medial side of the fifth metatarsal, then travel between the fifth metatarsal bone and lateral muscle group, pierce the aponeurosis, vascularize the skin of the anterior lateral plantar region, and finally anastomose with the lateral tarsal artery and the fourth dorsal metatarsal artery. At the point of origin, the mean sizes of the perforator of the fifth metatarsal base and head were 1.3 ± 0.2 and 0.9 ± 0.3 mm (mean ± SEM), respectively. The pedicle lengths were 2.6 ± 0.3 and 3.8 ± 0.5 cm, indicating the possibility of a free perforator flap.
  
  
  CONCLUSIONS
  The lateral plantar artery perforators are presented constant. The forefoot region can be repaired by the reverse perforator flap harvested pedicled with either the lateral plantar artery perforator from the base or head of the fifth metatarsal bone.
authors.affiliation: Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Oncology Plastic Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, China.|Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Dajiang
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China. hepingzheng111@163.com.
authors.forename: Heping
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Hou
authors.affiliation: Department of Orthopedics, Xinhua Hospital (Chongming) of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Xie
authors.affiliation: Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China.
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Zhuang
mesh_terms: D001158:Arteries / Q000033:anatomy & histology; D005528:Foot / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D013524:Surgical Flaps / Q000098:blood supply*
keywords: Forefoot defect; Perforator flap; The fifth metatarsal bone; The lateral plantar artery