Application Anatomy Of Tibia Bone Flap Transposition The Descending Branch Of Supramalleolar Artery As Pedicle

Objective:to discuss a new therapy for talus fracture, nonunions and avascular necrosis.Methods:anatomical observation of blood vessels on 10 cases(20 sides)adult lower limb corpse specimen,anatomical observation of supramalleolar artery origination,course,length,outer diameter and vascular anastomosis relationships with adjacent vessels,and bone flap transposition operation was performed and observed on sick lower limb in 8 cases with talus avascular necrosis.Results: supramalleolar artery originate from anterior tibial artery above the midpoint of collecting line between internal and external malleolus with the angle of 35°～60°etween two arteries,it descends close to the bone surface to tibial frontier gives ascending and descending branches.outer diameter and length of descending branch was (1.2±0.3)mm and (4.1±0.4)cm respectively,there are two accompanying veins with a outer diameter of (1.4±0.3)mm and (1.1±0.2)mm respectively, descending branch of supramalleolar artery is a periosteal branch, descending branch descend and anastomose with anterior ankle artery, descending branch has a tibial nourish theartery into distal tibia.Conclusion:The tibia bone flap the descending branch of supramall-eolar artery as pedicle provied a new simple therapy for talus fracture, nonunions and avascular necrosis.Objective:To investigate the value of clinical application of translocation of vascular pedicle of supramalleolar artery descending branches distal tibial flap treating avascular necrosis of talus.Methods:8 patients with traumatic ischemic necrosis of talus from march 2010 to december 2013 were treated by translocation of vascular pedicle of supramalleolar artery descending branches distal tibial flap, ankle joint were fixed with plaster slab for 4 weeks after operation.Results:The follow-up time from 6 to 24 months, mean 12 months. ankle joint function in the final follow-up were assessed according to kenwight curative effect standard, 6 cases were excellent,2 cases good.Conclusion:This bone flap has the advantages of constant vessels, abundant blood supply and the simple operation process, which is an effective method to treat avascular necrosis of talus.