Applied anatomy of the superior segment of fibula pedicled with anterior tibial recurrent vessels graft

Objective:To provide anatom ic basis forthe design offibula flap pedicled w ith the anteriortibial recurrent artery. M ethods:The origin,course,branchesand distribution ofanteriortibialrecurrentarterieswere observed and measured in 30 adult cadaveric limbs which were perfused with red latex. Results:Theanterior tibial recurrent artery originated from anterior tibial artery, and its arising site was (4.5±0.7)cm(3.0￣6.0cm) below apex of fibular head. The anterior tibial recurrent artery was (2.0±0.4)mm (1.3￣3.0mm) in diameterand (0.5±0.2)cm(0.2￣1.2 cm) in length of main trunk, and it was accompanied by 2 veins, which were (2.1±0.5)mm(1.5￣3.0 mm) and (2.6±0.4)mm(1.7￣3.2 mm) in diameter respectively. The anterior tibial recurrent arterygave off 1￣2 fibula head branches of (1.7 ±1.3)mm (0.6 ～2.1mm) in diameter, which distributed at theanteromedial surface of fibula head, and formed arterial rete on the superior segment of fibula with otherperiosteal branches. The length from ori of anterior tibial recurrent artery to ori of fibula head branch was(1.0±0.4)cm (0.3￣1.8 cm), with the percentage of the distance exceeding 1.0cm was 46.7%. The diameter ofanterior tibial recurrent artery was (1.4±0.5)mm(0.8￣2.1 mm) at the site of 1.5cm distal to the ori of fibula headbranch. Conclusions:The design offibula flap pedicaled w ith the anteriortibialrecurrentartery isfeasible,andit could offer a new choice of vessel pedicles for the transplantaion of vascularized superior segment of fibula.