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Anatomical basis of the reverse lateral plantar artery perforator flap design

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Background

This study aims to explore the characteristics of the formation and topography of lateral plantar artery perforators to identify a repair procedure for defects in the forefoot region.

Methods

Thirty-three cadavers were available for this anatomical study. The tuberosity of the fifth metatarsal bone was adopted as the anatomical landmark. The details of the lateral plantar artery perforators and the anastomosis between the lateral plantar artery perforators and other arteries of lateral foot were recorded.

Results

The perforators from the base and head of the fifth metatarsal bone constantly originate from the lateral plantar artery in the area of tuberosity of the fifth metatarsal, run along the medial side of the fifth metatarsal, then travel between the fifth metatarsal bone and lateral muscle group, pierce the aponeurosis, vascularize the skin of the anterior lateral plantar region, and finally anastomose with the lateral tarsal artery and the fourth dorsal metatarsal artery. At the point of origin, the mean sizes of the perforator of the fifth metatarsal base and head were 1.3 ± 0.2 and 0.9 ± 0.3 mm (mean ± SEM), respectively. The pedicle lengths were 2.6 ± 0.3 and 3.8 ± 0.5 cm, indicating the possibility of a free perforator flap.

Conclusion

The lateral plantar artery perforators are presented constant. The forefoot region can be repaired by the reverse perforator flap harvested pedicled with either the lateral plantar artery perforator from the base or head of the fifth metatarsal bone.

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Author notes

    Authors and Affiliations

    1. Department of Comparative Medicine, Fujian Medical University Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, China

      Lei Li, Heping Zheng, Zhiping Xie & Yuehong Zhuang

    2. Department of Oncology Plastic Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, China

      Dajiang Song

    3. Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, China

      Dajiang Song & Chunlin Hou

    4. Department of Orthopedics, Xinhua Hospital (Chongming) of Shanghai Jiao Tong University, Shanghai, China

      Jian Lin

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    1. Lei Li
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    2. Dajiang Song
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    3. Heping Zheng
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    Correspondence to Heping Zheng.

    Additional information

    L. Li and D. Song contributed equally to this work.

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    Li, L., Song, D., Zheng, H. et al. Anatomical basis of the reverse lateral plantar artery perforator flap design. Surg Radiol Anat 37, 983–988 (2015). https://doi.org/10.1007/s00276-015-1426-7

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    • DOI: https://doi.org/10.1007/s00276-015-1426-7

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