THE ARTERIAL SUPPLY OF THE ANKLE JOINT AND ITS IMPORTANCE FOR THE OPERATIVE FRACTURE TREATMENT

The operative exposure of a fracture causes disturbances in the blood supply, which may lead to a prolonged healing process or even to bone necrosis, especially when using the complex and complicated methods of osteosynthesis at the ankle. In order to damage the supplying vessels as little as possible, position, direction and penetration of the bon e arteries of the talocrural joint were examined by corrosion preparat ion. The tibial nutrient artery arises from the posterior tibial arter y or from the popliteal artery and penetrates constantly from posterio r at the lever of the proximal third. The fibular nutrient artery, com ing from the peroneal artery, penetrates more distaly from medial into the middle third of the diaphysis. In one specimen it did not exist a t all. Distal tibia and fibula are supplied by the perimalleolar arter ial ring, which is connected with the three arteries of the leg. The t alus is supplied by numerous very small vessels, which are provided wi th extraosseous anastomoses and penetrate the whole non-articular surf ace. Implications for the operation will be explained.