Reply: Islanded Posterior Tibial Artery Perforator Flap for Lower Limb Reconstruction: Review of Lower Leg Anatomy

摘要

Sir: We would like to thank Drs. Jack, Newman, and Barnavon for their communication regarding our article “Lower Limb Reconstruction Using the Islanded Posterior Tibial Artery Perforator Flap” (Plast Reconstr Surg. 2010;125:1735–1743). We would like to indeed confirm that the perforators from the posterior tibial artery emerge from between the flexor digitorum longus and the soleus, and between the tibia and the flexor digitorum longus in the distal third. In our experience and according to anatomical dissections, the periosteal perforators tend to be smaller that those passing between the flexor digitorum longus and the soleus, and we base our flap on the larger perforators emerging between the muscles. Manchot noted that “larger cutaneous arteries, as a rule, appear from the fissure between the soleus and flexor digitorum longus muscles.”1