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Surgical and Radiologic Anatomy

Erschienen in:

08.08.2023 | Original Article

The distal fibular perforating axial flap for lateral malleolus coverage: an anatomical description and surgical technique

verfasst von: Philippe Clavert, Benjamin Puliero, David Eichler, Irène Ollivier, François Bonnomet

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 10/2023

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Abstract

Purpose

Skin closure disorders in ankle surgery are a recurrent problem not only in traumatology but also in elective surgery. The aim of the study was to describe the anatomical basis of the fasciocutaneous vascularization of the lateral malleolus region to develop a posterior cover flap for the region.

Methods

We dissected ten fresh frozen specimens after arterial injection of an Indian ink preparation and individualized the perforating arteries. Their positions and diameters were collated. Then, the surgical technique was clinically applied for two different cases by transferring the fasciocutaneous flap posterior to the lateral malleolus to cover a loss of skin substance.

Results

There were in average 5 fibular perforators over the last 100 mm of the fibula. The average diameter of the first two perforating arteries was 0.6 ± 0.12 mm and 0.9 ± 0.25 mm, respectively, and the consistency of the latter makes it possible to produce a skin flap with anterior translation. This is an axial flap. Two patients were operated on using this technique. There was no necrosis of the posterior fibular flap and healing was achieved by the third post-operative week.

Conclusion

This study showed the presence of fibular perforating arteries with a high reproducibility of their dissection. This anatomical description served as the basis for the description of a new distal fibular perforating flap.

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Titel: The distal fibular perforating axial flap for lateral malleolus coverage: an anatomical description and surgical technique
verfasst von: Philippe Clavert
Benjamin Puliero
David Eichler
Irène Ollivier
François Bonnomet
Publikationsdatum: 08.08.2023
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 10/2023
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-023-03204-w

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The distal fibular perforating axial flap for lateral malleolus coverage: an anatomical description and surgical technique