Laurenz Weitgasser1, Sebastian Cotofana2, Marion Winkler3, Heinz Buerger3, Daniel Jamnig3, Friedrich Anderhuber4, Alexander Gaggl3. 1. Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Germany. Electronic address: laurenz.weitgasser@vinzenz.de. 2. Department of Anatomy, Ross University School of Medicine, Roseau, Dominica; Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria. 3. Department of Oral and Maxillofacial Surgery, Paracelsus Medical University of Salzburg, Austria. 4. Institute for Macroscopic and Clinical Anatomy, Medical University of Graz, Austria.
Abstract
OBJECTIVE: The aim of this study is to provide detailed information on the arterial variations of the descending geniculate artery (DGA) for the harvest of a cortico-periostal flap from the medial femoral condyle and a fascio-cutaneous perforator flap with its respective pedicles. MATERIAL AND METHODS: A total of 50 lower limbs from embalmed cadavers were dissected. The distribution pattern, length, and diameter of the DGA, saphenous artery (SA), muscular, periostal, and articular branches, and their concomitant veins were measured and evaluated. RESULTS: The DGA was present in 98% of the cases. In 80%, a Y-shaped distribution was identified where the SA branched from the DGA. Here, the mean lengths of DGA, SA, and the articular branch of the DGA were 3.2 ± 1.1, 7.18 ± 3.2, and 6.72 ± 2.07 cm, respectively. In 18%, an H-shaped distribution was noted, where the SA emerged directly from the femoral artery with a length of 10.2 ± 1.9 cm, whereas the length of the DGA (and its terminal articular branch) was 7.5 ± 1.5 cm. The mean length of the arterial pedicle for a cortico-periostal flap from the medial condyle was 9.92 cm, whereas for the fascio-cutaneous perforator flap, it was 9.46 cm in Y-shaped distribution and 10.2 cm for the H-shaped distribution. CONCLUSION: Different arterial distribution patterns increase the need for routine preoperative vascular imaging when planning to harvest a cortico-periostal flap and a fascio-cutaneous perforator flap from the medial femoral condyle, especially when a double-chimeric flap is targeted. LEVEL OF EVIDENCE: Level 4, case series.
OBJECTIVE: The aim of this study is to provide detailed information on the arterial variations of the descending geniculate artery (DGA) for the harvest of a cortico-periostal flap from the medial femoral condyle and a fascio-cutaneous perforator flap with its respective pedicles. MATERIAL AND METHODS: A total of 50 lower limbs from embalmed cadavers were dissected. The distribution pattern, length, and diameter of the DGA, saphenous artery (SA), muscular, periostal, and articular branches, and their concomitant veins were measured and evaluated. RESULTS: The DGA was present in 98% of the cases. In 80%, a Y-shaped distribution was identified where the SA branched from the DGA. Here, the mean lengths of DGA, SA, and the articular branch of the DGA were 3.2 ± 1.1, 7.18 ± 3.2, and 6.72 ± 2.07 cm, respectively. In 18%, an H-shaped distribution was noted, where the SA emerged directly from the femoral artery with a length of 10.2 ± 1.9 cm, whereas the length of the DGA (and its terminal articular branch) was 7.5 ± 1.5 cm. The mean length of the arterial pedicle for a cortico-periostal flap from the medial condyle was 9.92 cm, whereas for the fascio-cutaneous perforator flap, it was 9.46 cm in Y-shaped distribution and 10.2 cm for the H-shaped distribution. CONCLUSION: Different arterial distribution patterns increase the need for routine preoperative vascular imaging when planning to harvest a cortico-periostal flap and a fascio-cutaneous perforator flap from the medial femoral condyle, especially when a double-chimeric flap is targeted. LEVEL OF EVIDENCE: Level 4, case series.