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Anterior tibial artery injury is not the contraindication of medial plantar flap: digital subtraction angiography evidence and clinical application.

Authors :
Cang ZQ
Xu Y
Wang M
Xu MN
Yuan SM
Source :
Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2021 Oct; Vol. 74 (10), pp. 2512-2518. Date of Electronic Publication: 2021 Mar 30.
Publication Year :
2021

Abstract

The medial plantar artery (MPA) is often sacrificed as the vascular pedicle of the medial plantar flap (MPF). However, for patients with ankle soft tissue defect caused by traffic accident, the anterior tibial artery (ATA) could be damaged and the blood supply of the distal foot would only come from the MPA and the lateral plantar artery (LPA). In this case, sacrificing the MPA for the MPF means that the LPA will become the mainly source of blood supply of the distal foot. Whether the blood supply of the distal foot is adequately guaranteed remains to be discussed. A total of seven patients with ankle soft tissue defect and ATA injury were enrolled in the study. The digital subtraction angiography (DSA) was performed to observe the hemodynamics of the ipsilateral foot. The MPF was harvested only when the foot arterial network consisting of the MPA, the LPA, the deep plantar arch, and the deep plantar artery of DPA, and the blood redistribution existed. DSA results showed the blood from the posterior tibial artery was redistributed to the ipsilateral foot and the MPA is not the dominant artery in the foot. Seven MPFs were harvested, and all flaps survived completely. No complications, such as pain, ulcer, and necrosis, occurred in the ipsilateral toes. The DSA could accurately and intuitively evaluate the hemodynamics of foot in patients with ATA injury. The DSA data and clinical practice proved that the ATA injury is not the contraindication of the MPF.<br /> (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1878-0539
Volume :
74
Issue :
10
Database :
MEDLINE
Journal :
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
Publication Type :
Academic Journal
Accession number :
33941474
Full Text :
https://doi.org/10.1016/j.bjps.2021.03.054