Anatomic Study On Lower Rotating Point Nutrient Vessels Of Sural Nerve Flap

Neurocutaneous concomitant vessel island flap for repairing of soft tissuedefect was proposed and applied to clinical in1992. Sural neurovascular flap to repair the wound has many advantages like adjacent transfer,harvesting easy,alive rate high, has become a common district for ankle soft tissue defect repairing. But the flap rotating point is so high that transfer operation for repairingcaused larger damage to a patient, and more difficult to repair of distal foottrauma. In recent years, many clinical reports with lower rotating point suralneurocutaneous vascular flap to repair tissue defect of foot and ankle. But sofar,related anatomy and imaging of the reports were rare in the domestic, westudy the flap applied anatomy and imaging, in order to provide theoretical ev-idence for its clinical application.Objective: To provide anatomical and imagical basis for the applicationof the lower rotating point distally based sural nerve nutrient vessel pedicleflap. Method： Ten cadavers which were perfused by red latex were usedin this study. The lower leg superficial nerve and artery perforator origin, co-urse, branch, distribution of anatomical detailed were observed.Patients withnorm-al foot and ankle vascular did lower limb DSA contrast, collected caseinfor-mation, analysis the collected data to find the lower rotating point suralneurocutaneous nerve vascular location, walking and dynamic flow image, int-uitiveunderstanding of the blood supply. Results: In these series of10cada-ver (20sides) dissections,measured on10lateral sural nerve, its length is (13.5±5.0) cm. Measurement of sural nerve trunk diameter for the (2.5±1.2)mm in the1/2of median, and it descending taper. Peroneal artery perforatorand intermuscular septum nutritional vascular anastomosis constant, out diam- eter of anastomotic branch is (0.6±1.0) mm.The lateral sural artery gives o-ff2-5support, outer diameter (0.2±1.2) mm. Musculocutaneous perforatorpasses through the deep fascia and subcutaneous, forms the vascular network,and provides nutrition of lateral head of gastrocnemius muscle and the corres-ponding region of the skin The small saphenous vein in the distal end portio-n has the superficial and deep branches,located in the presence lateral of small saphenous vein accounted for75%(15sides), located in the small medialof saphenous vein accounted for25%(5sides). DSA developing effect is g-ood, there are1-2branches of superficial and deep on the lateral malleolusin3cm, relatively thick. Conclution: lower rotating point nutrient vessels ofsural nerve flap blood supply is reliable, donner area exiting fine, meet theneed of clinical application.