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Vascular basis of free transfer of proximal epiphysis and diaphysis of fibula: an anatomical study.
Arch Orthop Trauma Surg. 2009 Feb; 129(2):183-7.AO

Abstract

INTRODUCTION

Transfer of proximal epiphysis and diaphysis of fibula is a treatment of bony defects in children. Although there are few reports of this procedure, different arteries or combination of arteries have been used as supplying pedicle and the reported success rates are different. This is an anatomical study to clarify the vascular anatomy of this region.

MATERIALS AND METHODS

A total of 16 fresh cadavers were enrolled. An incision was made in the popliteal fossa to find the popliteal artery, which was dissected distally and the lateral inferior genicular artery, anterior tibial artery, tibioperoneal trunk and its bifurcation were located. In eight subjects popliteal artery was cannulated above the level of femoral condyles and injected by latex. In the next eight cases the same material was injected in the anterior tibial artery. The next steps of dissection were done by 4.3-loupe magnification. Lateral inferior genicular artery was dissected from its origin to the fibular head and branches of anterior tibial artery were also dissected. In three specimens, the fibula and its supplying arteries were removed after dissection and put in diluted hydrochloric acid to be opened for studying the medullary vasculature.

RESULTS

This study confirms the existence of not only periosteal but also intramedullary anastomosis between artery of the neck and peroneal artery. Artery of the neck was usually a branch of anterior tibial artery and in 24% of the subjects a branch of popliteal artery. In the latter condition the pedicle would be too short to permit the surgeon to do this surgery. Therefore preoperative angiography is mandatory to identify the origin of the artery of the neck.

CONCLUSION

According to these dissections, a classification system of arterial supply of proximal fibular epiphysis is introduced in this article.

Authors+Show Affiliations

Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. rasekhia@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18309505

Citation

Mozaffarian, Kamran, et al. "Vascular Basis of Free Transfer of Proximal Epiphysis and Diaphysis of Fibula: an Anatomical Study." Archives of Orthopaedic and Trauma Surgery, vol. 129, no. 2, 2009, pp. 183-7.
Mozaffarian K, Lascombes P, Dautel G. Vascular basis of free transfer of proximal epiphysis and diaphysis of fibula: an anatomical study. Arch Orthop Trauma Surg. 2009;129(2):183-7.
Mozaffarian, K., Lascombes, P., & Dautel, G. (2009). Vascular basis of free transfer of proximal epiphysis and diaphysis of fibula: an anatomical study. Archives of Orthopaedic and Trauma Surgery, 129(2), 183-7. https://doi.org/10.1007/s00402-008-0600-3
Mozaffarian K, Lascombes P, Dautel G. Vascular Basis of Free Transfer of Proximal Epiphysis and Diaphysis of Fibula: an Anatomical Study. Arch Orthop Trauma Surg. 2009;129(2):183-7. PubMed PMID: 18309505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vascular basis of free transfer of proximal epiphysis and diaphysis of fibula: an anatomical study. AU - Mozaffarian,Kamran, AU - Lascombes,Pierre, AU - Dautel,Gilles, Y1 - 2008/02/29/ PY - 2007/12/03/received PY - 2008/3/1/pubmed PY - 2009/4/21/medline PY - 2008/3/1/entrez SP - 183 EP - 7 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 129 IS - 2 N2 - INTRODUCTION: Transfer of proximal epiphysis and diaphysis of fibula is a treatment of bony defects in children. Although there are few reports of this procedure, different arteries or combination of arteries have been used as supplying pedicle and the reported success rates are different. This is an anatomical study to clarify the vascular anatomy of this region. MATERIALS AND METHODS: A total of 16 fresh cadavers were enrolled. An incision was made in the popliteal fossa to find the popliteal artery, which was dissected distally and the lateral inferior genicular artery, anterior tibial artery, tibioperoneal trunk and its bifurcation were located. In eight subjects popliteal artery was cannulated above the level of femoral condyles and injected by latex. In the next eight cases the same material was injected in the anterior tibial artery. The next steps of dissection were done by 4.3-loupe magnification. Lateral inferior genicular artery was dissected from its origin to the fibular head and branches of anterior tibial artery were also dissected. In three specimens, the fibula and its supplying arteries were removed after dissection and put in diluted hydrochloric acid to be opened for studying the medullary vasculature. RESULTS: This study confirms the existence of not only periosteal but also intramedullary anastomosis between artery of the neck and peroneal artery. Artery of the neck was usually a branch of anterior tibial artery and in 24% of the subjects a branch of popliteal artery. In the latter condition the pedicle would be too short to permit the surgeon to do this surgery. Therefore preoperative angiography is mandatory to identify the origin of the artery of the neck. CONCLUSION: According to these dissections, a classification system of arterial supply of proximal fibular epiphysis is introduced in this article. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/18309505/Vascular_basis_of_free_transfer_of_proximal_epiphysis_and_diaphysis_of_fibula:_an_anatomical_study_ L2 - https://dx.doi.org/10.1007/s00402-008-0600-3 DB - PRIME DP - Unbound Medicine ER -