New design and identification of the medial sural perforator flap: an anatomical study and its clinical applications

Plastic and Reconstructive Surgery
Hyo Heon KimByung Chae Cho

Abstract

Many studies have revealed facts about the anatomy of the medial sural artery perforator. The exact locations or areas where the perforators pierce through the fascia, however, have not been clearly identified. Based on cadaver dissections performed on 40 legs from 20 cadavers, the authors identified the location of the first and second perforators of the medial sural artery. The passages of the medial sural artery perforators were also confirmed by means of duplex-Doppler scanning, three-dimensional computed tomography, and angiography. The authors found that the main perforators of the medial sural artery were located on a line drawn from the midpoint of the popliteal crease to the midpoint of the medial malleolus. The hip joint was flexed in supine position and the knee joint was flexed into a 90-degree angle, thus making it possible to observe the first perforator, which was approximately 8 cm from the midpoint of the popliteal crease, and the second perforator, which was approximately 15 cm from the popliteal crease. A series of 21 clinical cases with soft-tissue defects were successfully treated using the medial sural artery perforator flap, including 18 free flaps and three pedicled flaps. There were seven cases of hand ...Continue Reading

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