Clinical Anatomic Study On The Original Of Cutaneous Branches Of Lateral Supramalleolar Flp

Objective:To study the original of lateral supramalleolar cutaneous branches and the course, distribution and branches of anterior tibial artery,peroneal artery and posterior tibial artery, provide anatomical guides for clinical treatments involving in lateral malleolar flaps.Methods:10 lower legs were selected randomly and were perfused with red latex by popliteal artery, to observe the arterial distribution,communication,branches and combination and measure interrelated data, diameters of posterior auriculary artery and superficial temporary artery. All the data was measured by vernier caliper, handled by spss 11.0 analysis system.Results:1. Anterior tibial artery run along the tibia bone laterally between the anterior tibial muscle and extensor hallucis longus muscle,the peroneal artery in the lower leg segment run through the fibula posterior,the deep surface of flexor hallucis longus muscle, on the lateral malleolus (6.12±3.18) cm,It issued perforator through the tibia and fibula interosseous membrane, after going (0.81±0.42) cm, the peroneal artery perforator and the anterior tibial artery made a communication in the tibialis anterior lateral, anterior tibial muscles, far from the lateral malleolus (4.21±3.16) cm, diameter at the anastomotic branch peroneal artery perforator as the beginning 1.45±0.31 mm, and diameter of anterior tibial artery 1.42±0.34 mm.10 cases of anatomical specimens, the beginning of the peroneal artery diameter greater than diameter of anterior tibial artery at the beginning were 7 cases (70%), anterior tibia] artery at the beginning of diameter greater than the diameter of the peroneal artery were 3 cases (30%)2. After anterior tibial artery communicated with peroneal artery perforator, It issued the lateral cutaneous branches and lateral malleolar branch artery. The cutaneous branches run through the deep fascia on the lateral malleolus, supply the skin around the lateral malleolus, the cutaneous branches of the superficial and deep fascia is divided into uplink and downlink support branch.3. Peroneal artery ran the interstitial space of the flexor hallucis longus muscle and fibular posterior, away from the lateral tip of 4.85±1.62cm issued traffic branch, The branch communicated with traffic branch of posterior tibial artery (from the lateral tip of 5.13±1.60cm).the length of traffic branch was 1.82±0.54cm, located at the top of the outer lateral, deep flexor hallucis longus muscle,the achilles tendon lateral, distance from the lateral tip 4.96±1.61cm。4. Peroneal artery wenr through the deep of peroneus brevis.After the transport between the branch of peroneal artery and the posterior tibial artery,the peroneal artery continued down along the posterolateral fibula,lateral malleolus and the Achilles tendon.Along the way may issue several posterolateral lateral cutaneous branches supply the skin, after ran across the bone around the lateral malleolus, the peroneal artery changed into the lateral terminal branch of the artery, with the lateral and anterior tibial artery arterial branches of the outer ankle built vascular network constitute the outer ankle, and walking down the line, and supply the skin and softConclusion:1. The peroneal artery perforator communicated with the traffic branch of anterior tibial artery from the lateral malleolus tip 6 cm. The traffic branch of peroneal artery communicated with the traffic branch of posterior tibial artery from the lateral malleolus tip 5 cm.2. After the peroneal artery perforator and the anterior tibial artery communicated with each other in the upper lateral malleolus, The peroneal artery perforator issued the lateral cutaneous branch and lateral malleolar branch, The cutaneous branch pierced the intermuscular septum and divided into 2-4 small cutaneous branches, nutrition, skin and soft tissue. The lateral malleolar branch continues downward.in the lateral malleolus and the talus in front of carina. in the groove,The lateral malleolar branch communicated with the lateral anterior tibial artery and the lateral tarsal artery3.After the transport between the branch of peroneal artery and the posterior tibial artery,the peroneal artery continued down. Along the way may issue several posterolateral lateral cutaneous branches supply the skin, after ran across the bone around the lateral malleolus, the peroneal artery changed into the lateral terminal branch of the artery.4.On the lateral lower leg area, the anterior tibial artery and peroneal artery, the peroneal artery and posterior tibial artery had a constant traffic branch to communicated with each other.and the traffic branch constantly issued cutaneous branch supply the parts of cutaneous skin and soft tissue. Provide anatomical support for the clinical application of lateral supramalleolus skin to design different pedicle flap or free skin flap for repairing skin defects.