The anatomical characteristics and clinical application of the lateral superior genicular artery perforator iliotibial band flap / 中华显微外科杂志

ABSTRACT

Objective To discuss anatomical characteristics and clinical results of the lateral superior genicular artery perforator iliotibial band flap. Methods From September 1999 to July 2009, the origin,course, branches and distribution of the lateral superior genicular artery and blood supply of iliotibial band were observed on 40 sides adult lower limbs perfused with red latax. Five perforator iliotibial band and 4 perforator iliotibial band flaps of 9 cases were treated with anastomosis of lateral superior genicular artery perforating rami. Results The lateral superior genicular artery of 35 cases (80%) originates from the popliteal artery. Its originated external diameter was (1.8 ± 0.4) mm. It divides into ascending branch and descending branch, and they gives off septofascio-cutaneous perforator, or anatomoses the lateral uppermost genicular artery in the vastus lateralis muscle, and then formes the musculocutaneous perforator of iliotibial band. The originated external diameter of the larger perforator of iliotibial bands was ( 1.0 ± 0.2) mm and they provides for the skin and iliotibial band of lateral superior genicular area. Nine cases, including 5 cases of simple Achilles tendon defects, two cases of achilles tendon defects with skin defects, and 2 cases of lower extremity and foot soft tissue defects were treated with transplantation of the vascularized iliotibial band (flap) with perforator vascular anastomoses. All cases were followed up 6 - 92 months. The results showed significant improvement in "heel test" and Thompson sign in the rerupture of the Achilles tendon occurred. Four perforator iliotibial band flaps survived well. Conclusion The lateral superior genicular artery perforator iliotibial band flap is a practical, simple and new donor in the reconstruction of soft tissue and composite defects.