[Anatomic study of the medial pedis composite flaps with saphenous nerve and tendon and its application].

OBJECTIVE: To investigate the anatomy of the medial pedis composite flaps with saphenous nerve and tendon and its application in the repair of tendo calcaneus and adjacent defects. METHODS: 10 cadavers (20 sides) were observed. The origin, course, size and the distribution of the medial plantar artery were studied. 12 cases with tendo calcaneus and adjacent defects were reconstructed with the medial pedis composite flaps with saphenous nerve. Donor site defects were covered with free skin graft. RESULTS: The medial plantar artery gives off deep branch [diameter (1.5 +/- 0.3) mm] and superficial branch [diameter (1.0 +/- 0.2) mm]. In 18 sides, the deep branches give off the medial branches and lateral branches. While in 2 sides, the superficial branches give off the medial branches and lateral branches with no big branches from the deep branches. There are branches of saphenous nerve and medial dorsal cutaneous nerve in the flap. All the flaps were survived. 8 cases were followed up for one months to one years. Good color, texture and function of the flaps were achieved. CONCLUSIONS: The medial pedis composite flaps with saphenous nerve can repair tendo calcaneus and adjacent defects. It is a easy and safe procedure with reliable anatomy and good results.

[Anatomical study and clinical applications of the posterior tibial artery intermuscular septum branches island flaps].

OBJECTIVE: To report an anatomical basis for the posterior tibial artery intermuscular septum branches island flaps and its clinical value. METHODS: The origin,course, number, caliber and distribution of the posterior tibial artery intermuscular septum branches were studied in 10 adult cadavers(20 legs). 10 cases of homonymy and opposite side ankle and adjacent soft tissue defects with posterior tibial artery intermuscular septum branches island flaps, aged 20-50 years. Free skin transplantation on the donor sites. RESULTS: The posterior tibial artery gives off 2-7 intermuscular septum branches. Its external diameter was about 0.4-1.8 mm,and the length was about 0.3-4.5 cm. The area of flaps was 7 cm x 6 cm - 20 cm x 8 cm in the group. All the flaps were survived except 1 with partial necrosis in the distant part(3 cm x 1 cm) of the flap. 7 cases were followed up two months to three years. The color, texture and appearance of the flaps were good. CONCLUSIONS: The kind of flap has reliable blood supply, the scope of repairing was wide; avoidance of sacrificing the major artery; the flap was easy to be dissected. It was one of the ideal flaps to repair the ankle and adjacent soft tissue defects.