Applied anatomy of the superficial peroneal artery perforator flap

Objective To provide morphological data that enables safe elevation of the superficial peroneal artery perforator flap.Methods Five fresh unfixed corpses underwent whole body red latex injection.Fifteen fresh cadavers injected with a modified lead oxide-gelatin mixture for three-dimensional reconstruction using a spiral computed tomography scanner and specialized software(MIMICS).All of specimens were then dissected by layers.Angiography and photography were used to document the precise course,size,location,and type of individual perforators in the anterolateral leg region.The surface areas of cutaneous territories and perforator zones were measured and calculated with Photoshop and Scion Image.Results The skin and muscles on the anterolateral leg are nourished by anterior tibial artery perforators and the descending branch of peroneal artery perforator.There were(7±3.0) perforators with diameters of greater than or equal to 0.5 mm.The average external diameter was(0.7±0.2) mm.Each perforator supplied an average area of(33.0±8.0) cm2.The diameter of the superficial peroneal artery was(1.2±0.3) mm at its origin from the anterior tibial artery below 5cm the head of the fibula,and the length was(5.6±1.8) cm.This artery was truly anastomoses with others perforaors to form the chain of superficial peroneal nerve accessory artery.Conclusions The anterolateral leg is an excellent donor site for local and distant flaps.Perforator flaps could be based on the chain of superficial peroneal nerve accessory artery.The volume rendering technique is very useful for preoperative flap design.