ArticleSurgical and radiologic anatomy : SRA2015
The localization of the distal perforators of posterior tibial artery: a cadaveric study for the correct planning of medial adipofascial flaps.
Article in Surgical and radiologic anatomy : SRA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Distal bipedicled "supra cross leg" flap: a salvage option for complex lower limb defects.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Flap Impaling: A Simple and Effective Technique in Soft Tissue Reconstruction of Complex Extremity Wounds.Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2026Article
- Risk factors related to the partial necrosis of the posterior tibial artery perforator-plus fasciocutaneous flap.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Radiological Evaluation of Postsurgical Course of Perforators in Retrograde Posterior Tibial Fasciocutaneous Flaps for Distal Leg and Foot Defects.Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2021Article
- Delineation the anatomy of posterior tibial artery perforator flaps using human cadavers with a modified technique.Surgical and radiologic anatomy : SRA · 2016Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe adipofascial flap, introduced by Lin in 1994, has many advantages compared to fasciocutaneous or free flaps. Its dissection is relatively easy and fast with low donor-site morbidity, and it does not alter the shape of the leg. The aim of this dissection study is to evaluate the anatomic localization of the most distal perforator of the posterior tibial vessels to provide an anatomical rationale for the safe harvesting of distally based medial adipofascial flaps of the leg. MATERIALS AND
methods30 Lower limbs from 15 cadavers were used for this study. The most distal perforator from posterior tibial perforator artery, accompanied by at least one vein, was identified and its distance from the medial malleolus was noted.
resultsA distal perforator was found in all specimens; the mean caliber was 0.77 mm. In all cases, the perforator artery passed in the septum between flexor hallucis longus m. and flexor digitorum longus m. and was accompanied by two veins. In our series, the distance between the lowest perforator and the medial malleolus ranged from 3.5 to 8.2 cm. The median was 6.75 cm, the 5th percentile 4 cm and the 95th percentile 8.1 cm. The mean distance of the perforator from the medial tibial border was 1.23 cm. The mean ratio between the distance of perforator from the medial malleolus and the total leg length was 21%.
conclusionCompared to all previous researches, our study has found more distal perforators from posterior tibial perforator artery. This fact may have important clinical consequences, because the anteromedial adipofascial flap would cover more distal soft tissue defects. Moreover, our data suggest some safety parameters to make the rising of a medial adipofascial leg flap safer in surgical practice.
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