Dissection and Permissible Levels of Proximal Mobilization of Anterior Tibial Vessels During Island Flaps Transfer

The article presents a discussion with the authors of previously published (Zelyanin D.A. et al. Features Extraction Anterior Tibial Vessels in Formation Vascularized Bone Grafts. Traumatology and Orthopedics Russia. 2022. Vol. 28, No 1. p. 89-99), as well on basis our own topographic anatomical studies, information about details topography branches anterior tibial vascular bundle (ATVB) permissible levels its proximal mobilization during island flaps transfer are justified.
 Topographic study was performed 32 non-fixed speciments lower extremities for substantiating plastic surgery skin isolated ATVB. arterial bed leg injected black natural latex Revultex, followed by precision dissection measurements all artery (ATA) diameter 0.3 mm or more using binocular magnifier magnification 3.3 times. All studied ATA were identified, number which varied from 26 to 49 (on average 38.53.2), 88.7% them went three muscles group leg. At same time, numbers departing each 10% intervals length determined, total values cross-sectional area these calculated. It found that 28% 39% cross-section localized first second leg, makes it possible justify limit Reasonable criteria choosing level ATVB are: location border is not higher than upper 20% assignment this border, at least 6 cm distal exit vessels into bone fascial sheath preservation four feeding bundles extending tibialis muscle (two bundles) extensor digitorum longus bundles).