Anterior tibial artery injury is not the contraindication of medial plantar flap: digital subtraction angiography evidence and clinical application |
| |
| Affiliation: | 1. Department of Plastic Surgery, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China;2. Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Xian, Shaanxi 710032, China;3. Department of Plastic Surgery, Jinling Hospital, Nanjing, Jiangsu 210002, China;4. Department of Plastic Surgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China;1. Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, No.1838 North Guangzhou Rd, Guangzhou, Guangdong 510515, People''s Republic of China;2. Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Road, Shijingshan District, Beijing 100144, People''s Republic of China;1. Department of Clinical medicine, The Second School of Medicine, Wenzhou Medical University, China;2. Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, China;3. Department of Post Anaesthesia Care Unit, The Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, China;1. Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children''s Hospital, Seattle, WA, USA;2. Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA;3. Division of Plastic Surgery, Department of Surgery, Phoenix Children''s Hospital, Phoenix, AZ, USA;1. Laboratory of Bioregenerative Medicine & Surgery, Division of Plastic Surgery, Weill Cornell Medicine, New York, NY, United States of America;2. Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States of America;1. Department of Reconstructive Plastic Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden;2. Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77 Stockholm, Sweden;3. Department of Craniofacial Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden;4. Department of Otorhinolaryngology, Head and Neck Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden;5. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden;1. Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany;2. Department of Neurology, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany;3. Current position: Department of Orthopaedic and Trauma Surgery, Martha-Maria Hospital, Nuernberg, Germany;4. Current position: Department of Urology, Fuerth Hospital, Fuerth, Germany |
| |
| Abstract: | The medial plantar artery (MPA) is often sacrificed as the vascular pedicle of the medial plantar flap (MPF). However, for patients with ankle soft tissue defect caused by traffic accident, the anterior tibial artery (ATA) could be damaged and the blood supply of the distal foot would only come from the MPA and the lateral plantar artery (LPA). In this case, sacrificing the MPA for the MPF means that the LPA will become the mainly source of blood supply of the distal foot. Whether the blood supply of the distal foot is adequately guaranteed remains to be discussed. A total of seven patients with ankle soft tissue defect and ATA injury were enrolled in the study. The digital subtraction angiography (DSA) was performed to observe the hemodynamics of the ipsilateral foot. The MPF was harvested only when the foot arterial network consisting of the MPA, the LPA, the deep plantar arch, and the deep plantar artery of DPA, and the blood redistribution existed. DSA results showed the blood from the posterior tibial artery was redistributed to the ipsilateral foot and the MPA is not the dominant artery in the foot. Seven MPFs were harvested, and all flaps survived completely. No complications, such as pain, ulcer, and necrosis, occurred in the ipsilateral toes. The DSA could accurately and intuitively evaluate the hemodynamics of foot in patients with ATA injury. The DSA data and clinical practice proved that the ATA injury is not the contraindication of the MPF. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
