Applied Anatomical Study On The Tibial Transplantation

Objective To study the possibility and practical method of the tibial transplantation.Methods 1. Sixty adult tibiae were chosen to observe and measure the related anatomic date, especially for the medial part of the tibia. 2. In forty legs of adult cadavers, the origin, distribution, branches and diameter of the tibial blood vessels were observed. The medial part of the tibia was divided into four regions (A, B, C, D). Stress of the observation was put on the intermuscular branches of the posterior tibial artery. 3. The biomechanical experiment was made by using SWD-10 machine in thirty tibiae which were from cadavers.Results 1. The average length of tibia was 349 + 2.2 mm; the mid-circumference length of tibia was 76. 7 +2.5 mm (man) and 68.7+2.4 mm (woman); the breadth of tibia at the mid-point of the medial surface was 24. 3+ 1.2 mm (man) and 22.1 +1.6 mm (woman). 2. The blood supply of tibia was mainly from the posterior tibial artery which was from the popliteal artery. The branches of the posterior tibial artery were the nutrient artery and intermuscular branches etc. There were rich anastomotic branches among the posterior tibial artery, anterior tibial artery and peroneal artery. The intermuscular artery has 2-6 branches. The length of B and C regions were 4.5 +0.4 mm and 3.8 +0.5 mm respectively. A and D regions were shorter and more narrow. The biomechanical experiment showed: For the ability of the anti-compression and bending stiffness of the tibia, no significant difference existed between the experimental groupand normal group if the removed bony flap was less than 200 (long) X 15 (wide) mm. Conclusions 1. The tibia is an ideal donor bone, especially for its medial part. It is convenient for the removal of the bone and the damage for the operation is less. 2. When transplanting, the intermuscular branch can be used as the artery of blood supply for the donor and the posterior tibial artery can be conserved. 3. When removing the tibial flap, the maximum can not be beyond 200mm X 15mm. 4. The whole tibia also can be used as a donor for allotransplantation of vascularized bone. In this case, the posterior tibial artery with the nutrient artery can be used for blood supply of the donor.