Abstract:

Objective　To provide anatomical basis for posterior tibial artery (PTA)intramuscular perforator flap.　Methods　Eight pieces of adult fresh calf specimens were dissected and the distribution of PTA perforators   and branches was analyzed. PTA perforator-based microdissected thin flap, conjoined flap, chimeric perforator flap and polyflap were designed and harvested.　Results    The average amount of septocutaneous perforators given off from PTA was 4.8 (3 to7), and the mean outer diameter was (1.10±0.29)mm; three relatively constant perforators were located in (6.7±1.1), (15.8±1.8) and (22.6±1.7) cm, respectively, above the medial malleolus. PTA perforators divided into cutaneous branches,periosteal branch and muscular branches beneath the deep fascia. The perforators from the periosteal branch mainly concentrate on the middle segment of the calf. Perforators which divided into two cutaneous branches with an initial outer diameter great than or equal to 0.5 mm are mainly located in the middle and upper segments of the calf.　Conclusions　The first and second perforators of PTA are relatively constant in the middle and upper segments of the calf, with larger outer diameter and longer pedicle, which can divide into multiple branches supplying various tissues. It is suitable for harvesting PTA perforator-based microdissected thin flap, conjoined flap, chimeric perforator flap and polyflap.

Key words: Posterior tibial artery, 　Perforator, 　Flap, 　Applied anatomy