THE ANATOMIC BASIS AND CLINICAL-APPLICATIONS OF FLAPS BASED ON THE POSTERIOR TIBIAL VESSELS

The vascular anatomy of the posterior tibial vessels has been studies in 20 legs of 10 cadavers. The number, size and distribution of the di rect cutaneous and direct muscle branches of the posterior tibial vess els were recorded. For analysis, the leg was divided into four equal s egments, Zone I being the most distal and Zone IV the most proximal. T he direct cutaneous branches were found to cluster mainly around Zone II. The direct muscle branches to the soleus and flexor digitorum long us muscles arose chiefly in Zones II and III. Based on this knowledge, we performed fasciocutaneous, island soleus muscle, musculo-fasciocut aneous and flexor digitorum longus muscle flaps based on the posterior tibial vessels in 12 patients. Four were free fasciocutaneous flaps a nd eight were pedicled flaps. All flaps survived and there were no maj or complications. Delayed wound heating was encountered in three patie nts.