The Anterior Tibial Artery Flap

Rocha, Julierme Ferreira; Gilbert, A; Masquelet, A. C.; Yousif, N. John; Sanger, James R.; Matloub, Hani S.

doi:10.1097/00006534-198703000-00014

Cited by 35 publications

(2 citation statements)

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“…It is worth mentioning that the perforator originating from SLPA can extend the pedicle of the flap by 4.3-6.8 cm by the superior lateral peroneal artery, which might also explain why the length of the perforator reported in different studies was so different [2,4,14]. Moreover, the extension of the pedicle means that the anterior tibial artery does not need to be sacrificed when dissecting the flap, thus avoiding the risk of necrosis of the lower limbs [1]. Kim et al proved that the SPNAA perforator was constant and designed an SPNAA perforator flap to repair 12 defects [15].…”

Section: Discussionmentioning

confidence: 99%

“…A pedicled anterior tibial artery flap was first designed in 1987 by Rocha et al to repair the tissue defects of the knee, heel, and medial malleolus. They found that the anterior tibial artery flap was thin and easy to dissect in the supine position, thus being suitable for repairing the soft tissue defects in lower limbs [1]. Later, many scholars further studied the perforator of anterior tibial artery, dividing it into following three types based on the origin: perforator originating from the anterior tibial artery (ATA perforator), superior lateral peroneal artery (SLPA perforator), and superficial peroneal nerve accessory artery (SPNAA perforator) [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Three‐Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities

Shi¹,

Xu²,

Fan³

et al. 2023

World j. surg.

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Background Traditional research methods have limited the application of anterior tibial artery perforator flap due to incomplete knowledge of the perforator. This study aimed to investigate the feasibility of three‐dimensional digitalized virtual planning of free anterior tibial artery perforator flap for repairing soft tissue defects in extremities. Methods A total of 11 patients with soft tissue defects in extremities were included. The patient underwent computed tomography angiography (CTA) of bilateral lower limbs, and then the three‐dimensional models of bones, arteries, and skin were constructed. Septocutaneous perforators with appropriate length and diameter were selected to design anterior tibial artery perforator flaps in software, and the virtual flaps were superimposed onto the patient's donor site in a translucent state. During the operation, the flaps were dissected and anastomosed to the proximal blood vessel of the defects as designed. Results Three‐dimensional modeling showed clear anatomical relationships between bones, arteries, and skin. The origin, course, location, diameter, and length of the perforator obtained during the operation were consistent with those observed preoperatively. Eleven anterior tibial artery perforator flaps were successfully dissected and transplanted. Postoperative venous crisis occurred in one flap, partial epidermis necrosis occurred in another flap, while the remaining flaps completely survived. One flap was treated with debulking operation. The remaining flaps maintained aesthetic appearance, which did not affect the function of the affected limbs. Conclusions Three‐dimensional digitalized technology can provide comprehensive information on anterior tibial artery perforators, thus assisting in planning and dissecting patient‐specific flaps for repairing soft tissue defects in extremities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three‐Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities

Shi¹,

Xu²,

Fan³

et al. 2023

World j. surg.

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Emergency knee joint salvage utilizing a free musculofasciocutaneous flap based on the anterior tibial artery: Case report

et al. 1989

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A young adult male presented with a traumatic amputation at the upper third of his left leg and an extensive soft tissue loss around his left knee. A free musculofasciocutaneous flap was elevated on the anterolateral part of the amputated segment and transferred to the soft tissue defect around the proximal left tibia in order to avoid an above-knee amputation. The entire flap depends on the anterior tibial artery for its blood supply. The anatomy of the flap is outlined. The importance of the musculocutaneous blood supply as well as the presence of an extensive fascial component make the flap very reliable. An 18-month follow-up period showed a uniformly well-contoured soft tissue coverage and an optimal functional result.

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A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?

et al. 2013

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Soft tissue coverage in the distal lower extremity remains a significant challenge. While free flaps are often utilized for larger defects, local perforator-based propeller flaps may be ideal for smaller wounds requiring coverage. Propeller flaps can provide excellent form and function for both traumatic and atraumatic defects with minimal donor site morbidity but can have concerning rates of flap loss. We reviewed the literature, identifying 21 studies presenting 310 propeller flaps for distal lower extremity reconstruction. Total flap necrosis was noted in 5.5% of flaps, with partial necrosis in 11.6%. While these flaps do enable transfer of local, healthy tissue to the defect site without the need for a microsurgical anastomosis, this rate of flap loss is concerning and appropriate patient selection is crucial. This review provides a brief history and overview of the clinical application and research into distal lower extremity perforator propeller flaps to place this technique into a clinical context.

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The Anterior Tibial Artery Flap

Cited by 35 publications

References 0 publications

Three‐Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities

Three‐Dimensional Digitalized Virtual Planning of Free Anterior Tibial Artery Perforator Flap for Repairing Soft Tissue Defects in Extremities

Emergency knee joint salvage utilizing a free musculofasciocutaneous flap based on the anterior tibial artery: Case report

A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?

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