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Perforators of the fibular artery and suprafascial network

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Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Introduction

Soft tissue defect on lower limb can result in an intractable wound. Surgeons resort in flaps to cover these injuries. Including fascia as in the case of a fasciocutaneous flap increases survey of the flap. Rising a perforator flap avoids to sacrifice a major vessel whence the nourishing perforator artery is born. We wanted to explore suprafascial distribution of the fibular skin perforator arteries supposing possible to find out a vascular axis composed of anastomoses of the fibular perforator vessels.

Materials and methods

Systematic observation was carried out on ten injected legs about the fibular perforator distribution, and especially their suprafascial course.

Results

Dissection allowed us to raise in all specimens a large fasciocutaneous paddle including a fine arteriolar vessel connecting fibular perforators. Perforators were isolated along from the leg and we found suprafascial arteriole connecting all perforators from the fibular head to the lateral malleolus. There were a total number of 126 perforators for 10 legs. The mean length of the fibula was 32.9 cm. No perforator was located at more than 2 cm from fibular posterior border. Proximal perforators were closer to posterior fibular side than distal perforators. We found that fibular perforators clustered in the middle and upper third of the leg.

Conclusion

This study proves the real existence of a microvascular suprafascial axis formed by fibular perforator anastomoses and stretching over the entire length of the fibula, from the fibular head to the distal tip of the lateral malleolus. This suprafascial vascular axis could be an anatomical basis for a fasciocutaneous fibular flap.

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Authors and Affiliations

  1. Laboratory of Anatomy, School of Surgery, Assistance Publique des Hôpitaux de Paris, 7 rue du Fer à Moulin, 75221, Paris cedex 05, France

    Julien Gaillard, Laurent-Marie Bourcheix & Alain-Charles Masquelet

  2. Department of orthopaedic, traumatology and reconstructive surgery, Hôpital Saint-Antoine, 184, rue du Fg Saint Antoine, 75571, Paris, France

    Julien Gaillard & Alain-Charles Masquelet

  3. Groupe Hospitalier Paris Est, Assistance Publique des Hôpitaux de Paris, Paris, France

    Julien Gaillard & Alain-Charles Masquelet

  4. IFCM-Institut Français de Chirurgie de la Main, 5 Rue du Dôme, 75116, Paris, France

    Laurent-Marie Bourcheix

Authors
  1. Julien Gaillard
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  2. Laurent-Marie Bourcheix
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  3. Alain-Charles Masquelet
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Correspondence to Julien Gaillard.

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The authors declare that experiments of this research project comply with the current laws of the country.

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The authors declare that they have no conflict of interest, no financial interests in this research project or in any of the techniques or equipment used in this study.

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Gaillard, J., Bourcheix, LM. & Masquelet, AC. Perforators of the fibular artery and suprafascial network. Surg Radiol Anat 40, 927–933 (2018). https://doi.org/10.1007/s00276-017-1927-7

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  • DOI: https://doi.org/10.1007/s00276-017-1927-7

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