Anatomic characterization of the tibial and fibular nutrient arteries in humans

Anetai, Hidaka; Kinose, Shota; Sakamoto, Riku; Onodera, Rumiko; Kato, Kota; Kawasaki, Yuto; Miyaki, Takayoshi; Kudoh, Hiroyuki; Sakai, Tatsuo; Ichimura, Koichiro

doi:10.1007/s12565-020-00600-9

Cited by 8 publications

(9 citation statements)

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“…Kotsougiani et al [ 19 ] dissected the hindlimbs of 8 pigs and collected data on the source, length, and caliber of nutrient arteries in their tibias. The results they reported were highly similar to those derived from human tibias dissected by Anetai et al [ 9 ]. Therefore, using porcine tibias as an experimental material to investigate the distribution of intraosseous arteries can help researchers to deepen their understanding of human intraosseous arteries.…”

Section: Discussionsupporting

confidence: 88%

“…Superior distance, distance between the nutrient foramen and the epiphyseal plate above the tibia; Inferior distance, distance between the nutrient foramen and the epiphyseal plate below the tibia; Relative position of nutrient foramen, Superior distance/(Superior distance + Inferior distance); x ± s, mean ± the standard deviation tibias. The results they reported were highly similar to those derived from human tibias dissected by Anetai et al [9]. Therefore, using porcine tibias as an experimental material to investigate the distribution of intraosseous arteries can help researchers to deepen their understanding of human intraosseous arteries.…”

Section: Selection Of Experimental Materialssupporting

confidence: 82%

“…The intraosseous vessels of the tibia are mainly derived from the nutrient artery. In the past few decades some scholars have summarized the origin and course of nutrient arteries outside the bone via anatomical or imaging studies of human specimens [ 9 , 10 ]. However, there is no better method to clearly and intuitively display the nutrient arteries in the tibia, and there is also a lack of relevant visual models for use in clinical teaching.…”

Section: Introductionmentioning

confidence: 99%

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Method for generating transparent porcine tibia showing the intraosseous artery

et al. 2022

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Background The occurrence of nonunion after tibial fracture surgery is mainly related to insufficient blood supply. Therefore, anatomical study of the internal and external tibial artery is very important, but there is no good method for displaying the intraosseous artery clearly and intuitively. This hinders the protection and reconstruction of it by surgeons, as well as the development of new instruments and techniques by researchers. Objective To develop a transparent specimen that could clearly display the intraosseous artery of the tibia. Methods In 10 isolated pig calves with popliteal vessels, the popliteal artery was exposed and a tube was placed. A casting agent was then injected at constant pressure, and the tissue around the blood vessel was preliminarily removed after solidification. The perivascular tissue and periosteum were further removed via alkali corrosion, and the tibia was fixed with an external fixator to protect the non-corrosive areas at both ends. Alternate acid corrosion and flushing were then applied until the intraosseous artery was completely exposed. The distribution and branches of intraosseous nutrient arteries were observed with the naked eye and via microscopy. Three-dimensional (3D) scanning and 3D printing filling techniques were used to make transparent tibia specimens with preservation of intraosseous arteries. Results A cast specimen of the intraosseous artery of porcine tibia was successfully generated via epoxy resin perfusion combined with acid–alkali etching, and the intraosseous artery was clearly visible. The 3D printing and filling technique successfully produced a transparent tibia specimen with preservation of internal bone arteries, and accurately restored the external shape of the tibia. The foramen of the nutrient artery appeared near the middle upper third of the lateral edge of the tibia. After entering the tibia, the nutrient artery proceeded forward, medial, and downward for a certain distance, twisted and turned near the midpoint of the medullary cavity, and divided into the ascending and descending branches. After going in the opposite direction for a distance, the ascending trunk sent out 2–3 branches, and the descending trunk sent out 2–3 branches. Conclusion The cast specimen of pig intraosseous artery generated via the above-described perfusion corrosion method provides methodological guidance for the study of anatomical characteristics of the intraosseous artery, and a theoretical basis for the study of new methods of internal fixation and reconstruction of the blood supply of the lower tibia.

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Section: Discussionsupporting

confidence: 88%

Section: Selection Of Experimental Materialssupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Method for generating transparent porcine tibia showing the intraosseous artery

et al. 2022

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“…Kotsougiani et al [13] dissected the hindlimbs of 8 pigs and collected data on the source, length, and caliber of nutrient arteries in their tibias. The results they reported were highly similar to those derived from human tibias dissected by Anetai et al [9]. Therefore, using porcine tibias as an experimental material to investigate the distribution of intraosseous arteries can help researchers to deepen their understanding of human intraosseous arteries.…”

Section: Selection Of Experimental Materialssupporting

confidence: 82%

Method for generating transparent porcine tibia showing the intraosseous artery

Wang

Wan

Geng

et al. 2022

Preprint

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Background: The occurrence of nonunion after tibial fracture surgery is mainly related to insufficient blood supply. Therefore, anatomical study of the internal and external tibial artery is very important, but there is no good method for displaying the intraosseous artery clearly and intuitively. This hinders the protection and reconstruction of it by surgeons, as well as the development of new instruments and techniques by researchers.Objective: To develop a transparent specimen that could clearly display the intraosseous artery of the tibia.Methods: In 10 isolated pig calves with popliteal vessels, the popliteal artery was exposed and a tube was placed. A casting agent was then injected at constant pressure, and the tissue around the blood vessel was preliminarily removed after solidification. The perivascular tissue and periosteum were further removed via alkali corrosion, and the tibia was fixed with an external fixator to protect the non-corrosive areas at both ends. Alternate acid corrosion and flushing were then applied until the intraosseous artery was completely exposed. The distribution and branches of intraosseous nutrient arteries were observed with the naked eye and via microscopy. Three-dimensional (3D) scanning and 3D printing filling techniques were used to make transparent tibia specimens with preservation of intraosseous arteries.Results: A cast specimen of the intraosseous artery of porcine tibia was successfully generated via epoxy resin perfusion combined with acid-alkali etching, and the intraosseous artery was clearly visible. The 3D printing and filling technique successfully produced a transparent tibia specimen with preservation of internal bone arteries, and accurately restored the external shape of the tibia. The foramen of the nutrient artery appeared near the middle upper third of the lateral edge of the tibia. After entering the tibia, the nutrient artery proceeded forward, medial, and downward for a certain distance, twisted and turned near the midpoint of the medullary cavity, and divided into the ascending and descending branches. After going in the opposite direction for a distance, the ascending trunk sent out 2–3 branches, and the descending trunk sent out 2–3 branches.Conclusion: The cast specimen of pig intraosseous artery generated via the above‑described perfusion corrosion method provides methodological guidance for the study of anatomical characteristics of the intraosseous artery, and a theoretical basis for the study of new methods of internal fixation and reconstruction of the blood supply of the lower tibia.

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“…In contrast, only one entered from the posterior surface and showed, on average, a diameter of 0.9 mm – 1.5 mm ( 45 ). Based on 54 cadaveric legs, it was found that the fibular nutrient artery, which arose from the fibular artery as a short descending branch, penetrated the M. flexor hallucis longus to enter the fibular nutrient foramen ( 46 ). Between the distal half of the first-quarter and second-quarter segments of the fibula, the fibular nutrient artery, and up to three arcuate arteries were located constantly ( 47 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of Periosteal Branches and Septo-Cutaneous Perforators on Free Fibula Flap Outcome: A Retrospective Analysis of Computed Tomography Angiography Scans in Virtual Surgical Planning

et al. 2022

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BackgroundVirtual surgical planning (VSP) for jaw reconstruction with free fibula flap (FFF) became a routine procedure and requires computed tomography angiography (CTA) for preoperative evaluation of the lower limbs vascular system and the bone. The aim of the study was to assess whether the distribution and density of periosteal branches (PB) and septo-cutaneous perforators (SCP) of the fibular artery have an impact on flap success.MethodThis retrospective clinical study assessed preoperative CTA of the infra-popliteal vasculature and the small vessel system of 72 patients who underwent FFF surgery. Surgical outcome of flap transfer includes wound healing, subtotal, and total flap loss were matched with the segmental vascular supply.ResultA total of 72 patients (28 females, 38.9 %; 44 males, 61.1 %) fulfilled the study inclusion criteria. The mean age was 58.5 (± 15.3 years). Stenoses of the lower limbs’ vessel (n = 14) were mostly detected in the fibular artery (n = 11). Flap success was recorded in n = 59 (82.0%), partial flap failure in n = 4 (5.5%) and total flap loss in n = 9 (12.5%). The study found a mean number (± SD) of 2.53 ± 1.60 PBs and 1.39 ± 1.03 SCPs of the FA at the donor-site. The proximal FFF segment of poly-segmental jaw reconstruction showed a higher rate of PB per flap segment than in the distal segments. Based on the total number of prepared segments (n = 121), 46.7% (n = 7) of mono-, 40.4% (n = 21) of bi-, and 31.5 % (n = 17) of tri-segmental fibula flaps were at least supplied by one PB in the success group. Overall, this corresponds to 37.2% (45 out of 121) of all successful FFF. For total flap loss (n = 14), a relative number of 42.9% (n = 6) of distinct supplied segments was recorded. Wound healing disorder of the donor site was not statistically significant influenced by the detected rate of SCP.ConclusionIn general, a correlation between higher rates of PB and SCP and the flap success could not be statistically proved by the study sample. We conclude, that preoperative PB and SCP mapping based on routine CTA imaging is not suitable for prediction of flap outcome.

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Anatomic characterization of the tibial and fibular nutrient arteries in humans

Cited by 8 publications

References 19 publications

Method for generating transparent porcine tibia showing the intraosseous artery

Method for generating transparent porcine tibia showing the intraosseous artery

Method for generating transparent porcine tibia showing the intraosseous artery

Impact of Periosteal Branches and Septo-Cutaneous Perforators on Free Fibula Flap Outcome: A Retrospective Analysis of Computed Tomography Angiography Scans in Virtual Surgical Planning

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