Anatomical study on sural nerve nutrient vessels of the distally based flap

Fahui ZHANG; Heping ZHENG; Yiping SONG; Suqin YUE

ABSTRACT

BACKGROUND:

There exists insufficient study with specific applicability regarding vascular distribution characteristics of sural nerve nutrient vessels of the distally based flap.

OBJECTIVE:

To investigate the distribution of sural nerve nutrient vessels of the distally based flap and provide an anatomical evidence for the design of operation on repair of foot injury.

DESIGN:

A single sample study.

SETTING:

Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA, and Department of Orthopaedics, the 97 Hospital of Chinese PLA.

PARTICIPANTS:

Thirty-two samples of lower extremities whose blood vessels were perfused with red emulsion were provided by Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA.

METHODS:

The origin of the blood vessels of distally based flap and deep communicating branches of the lesser saphenous vein in the samples were dissected and observed.MAIN OUTCOME

MEASURES:

①The nutrient vessels of sural nerve of distally basde flap.②The nutrient vessels of lesser saphenous vein of distally based flap.③The superficial and deep communicating branches of lesser saphenous vein of distally based flap.

RESULTS:

There were 2 to 5 nutrient vessels in the distally based flapone originating from the perforating branch of the lateral calcaneal artery was (0. 6 ± 0.2) mm in diameter and one from the terminal perforating branch of the peroneal artery was(0.8±0. 2) mm in diameter and they were (1.0 ± 1.3) and(2. 8 ± 1.0) cm, respectively, away from the lateral malleolus. The incidence of intermuscular septum perforating branches (0 to 3) was 96. 7%, 66.7% and 20. 0%, respectively, and their diameter was (0.9 ±0. 3), (1.0 ±0. 2) and (0. 8 ±0. 4) mm and their distance to lateral malleolus was(5.3 ±2. 1), (6. 8 ±2.8) and (7.0 ±4.0) cm, respectively. There were 2 types of nutrient vessels of the lesser saphenous vein of distally based flap, the nutrient vessels of nerve-vein and the ones of vein-nerve. The superficial and deep communicating branches of the lesser saphenous vein were(1.7 ±0. 5) mm in diameter and(3.4 ±0. 9) cm away from the lateral malleolus. They ended at the peroneal veins.

CONCLUSION:

The perforating branches of heel lateral artery, the terminal perforating branches and intermuscular septum perforating branches of the peroneal artery have sub-branches to deep fascia, skin, nerves and parenteral nutrient vessels. These sub-branches communicate and form vascular chain of lesser saphenous vein to sural nerve and vascular network of superficial and deep fascia. The superficial and deep communicating branches end at the peroneal veins.