Medial lower leg perforators: An anatomical study of their distribution and characteristics

Hupkens, Pieter; Westland, Pèdrou B.; Schijns, Wendy; Abeelen, Marjolijn H.A. van; Kloeters, Oliver; Ulrich, Dietmar

doi:10.1002/micr.30076

Cited by 16 publications

(12 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lower leg reconstruction often requires the use of local perforator flaps, based on either the tibialis posterior artery [15][16][17][18] or the peroneal artery [8,[19][20][21][22][23][24]. Propeller and advancement flaps for reconstruction of the lower extremity are the most widely used local flaps in the leg, and often constitute the final reconstructive option before a distant free flap is required [2,25].…”

Section: Discussionmentioning

confidence: 99%

The suprafascial course of lower leg perforators: An anatomical study

Vaienti

Cottone²,

Francesco

et al. 2020

Arch Plast Surg

View full text Add to dashboard Cite

Background Perforator mapping has been well described in the literature. Once the suprafascial plane is reached, the course of perforators is considered constant. However, the surgeon must be aware of whether an anastomosis exists between perforators superficially to the fascia, in order to choose the best vessel upon which to base the reconstruction. Our retrospective in vivo anatomical study of lower leg perforator flaps presents the first description of variations in the suprafascial path of perforators, which may influence preoperative flap design. Methods An anatomical study of lower limb perforators was performed on 46 nonconsecutive patients who were referred to our department from June 2012 to October 2018. Reconstruction with perforator-based propeller flaps was planned for each of the patients. In total, 72 perforators were preoperatively identified and surgically isolated. The suprafascial course of each perforator was reported. Results During suprafascial surgical exploration, branching patterns were observed in four perforators. These perforators had been classified as single vessels in the preoperative ultrasonographic analysis. However, after surgical dissection, distal converging branches were noted in two of them. Conclusions Our study is the first description in the literature of suprafascial converging perforators, which might constitute an obstacle to planned reconstruction procedures. Despite the accuracy of preoperative evaluations, anatomical variations were present. Knowledge of suprafascial perforator variations may help surgeons to choose the correct perforator upon which to base a planned flap.

show abstract

Section: Discussionmentioning

confidence: 99%

The suprafascial course of lower leg perforators: An anatomical study

Vaienti

Cottone²,

Francesco

et al. 2020

Arch Plast Surg

View full text Add to dashboard Cite

show abstract

“…However, knowledge about this body area is still far from complete. While the importance of the topic was recognized, it is still fairly insufficiently researched (for example, the posterior lower leg skin and its vascular anatomy [11][12][13] illustrate this statement). Implications of such theoretical gaps extend into the practice.…”

Section: Discussionmentioning

confidence: 99%

“…After that, a long stream of researches followed. Hupkens et al 13 conducted an anatomical study to localize and classify the lateral lower leg perforators. The same author gave his contribution by researching the medial lower leg perforators, their distribution and characteristics.…”

Section: Discussionmentioning

confidence: 99%

Anatomic study of septocutaneous system of the human fetuses’ lower leg: Posterior tibial artery

et al. 2019

View full text Add to dashboard Cite

Background/Aim. Lower-leg septocutaneous system of perforating blood vessels represents the vascular basis of fasciocutaneous flaps. Additionally, it is of a particular importance when designing distally based fasciocutaneous flaps which represent the "workhorse" in the reconstruction of the distal third of the lower leg and foot. The aim of this study was to analyse the vascular anatomy of posterior tibial artery and its septocutaneous (fasciocutaneous) perforating arterial vessels. Methods. The dissection was conducted on 20 fetuses of both sexes and of gestational age from 20 to 28 weeks. Cluster analysis was applied to the data on vascular anatomy of posterior tibial artery and its septocutaneous performating arterial vessels. Results. A total of 212 perforating arterial vessels was identified. The average number of perforating arterial vessels was 5.32 (ranging from 4 to 7). It

show abstract

“…The antero-lateral aspect of the lower leg is rich in septocutaneous perforators and can be utilized in pedicled flaps or free flaps to reconstruct structural defects, such as those arising secondary to chronic diseases or following trauma. [5][6][7] There are numerous flaps used for intraoral reconstructions and to cover lower limb defects. However, they can be associated with significant comorbidity and impair distal arterial supply.…”

Section: Introductionmentioning

confidence: 99%

Superficial peroneal nerve accessory artery (SPNAA) flap for head and neck reconstruction: A cadaveric anatomical study and retrospective case series review

Stocco

Murphy

Gargiulo

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

Medial lower leg perforators: An anatomical study of their distribution and characteristics

Abstract: In each third of the MLLR different perforator characteristics were found. Knowledge of these characteristics can be used to direct the reconstructive plan. © 2016 Wiley Periodicals, Inc. Microsurgery 37:319-326, 2017.

Cited by 16 publications

References 39 publications

The suprafascial course of lower leg perforators: An anatomical study

The suprafascial course of lower leg perforators: An anatomical study

Anatomic study of septocutaneous system of the human fetuses’ lower leg: Posterior tibial artery

Superficial peroneal nerve accessory artery (SPNAA) flap for head and neck reconstruction: A cadaveric anatomical study and retrospective case series review

Contact Info

Product

Resources

About