|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
C. Cross-section of the leg. The four muscle compartments of the leg
are identified: anterior, lateral superficial posterior, and deep posterior.
The fibula lies between the lateral and posterior muscle groups. Both the
peroneal artery, closely related to the fibula, and the posterior tibial
artery lie in the posterior compartments. The anterior tibial artery is
anterior to the interosseous membrane but is also close by. The shaded areas
represent the muscle cuff included in the transplant to maintain the important
periosteal supply to the bone.
PLATE XVI-2. Donor Site
A. The incision is made longitudinally along the posterior border of the skin island and subcutaneous palpable borders of the fibula. The common peroneal nerve running around the fibular neck proximally must be carefully avoided.
C. Once the fibula has been divided, dissection is carried onto the anterior surface and then to the posterior surface of the bone from distal to proximal. During this dissection, the peroneal artery is identified in the posterior compartment and is doubly ligated distal to the osteotomy site and divided. A cuff of thin muscle is left attached to the fibula so that the peroneal vessels and their connections to the bone are protected as proximal dissection is carried out medially to free the bone.
|Ch. 16 Page 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15|