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Potential donor rotational bone grafts using vascular territories in the foot and ankle.

Publication ,  Journal Article
Gilbert, BJ; Horst, F; Nunley, JA
Published in: J Bone Joint Surg Am
September 2004

BACKGROUND: An improved understanding of the extraosseous and intraosseous blood supply of the distal aspect of the tibia, distal aspect of the fibula, cuboid, and cuneiforms should identify vascular territories that would enable surgeons to perform rotational vascularized pedicle bone-grafting procedures in the foot and ankle. METHODS: We investigated the blood supply of twenty cadaveric lower extremities using two vascular injection techniques. In order to define the extraosseous and intraosseous arterial anatomy in this region, ten specimens were sequentially subjected to injection with Batson's compound, soft-tissue digestion, and bone-clearing according to a modified Spalteholz technique. To further characterize the extraosseous vascular anatomy, the other ten specimens were injected with latex and dissected. RESULTS: We identified a consistent and previously unnamed blood supply to the distal aspect of the tibia, distal aspect of the fibula, cuboid, and cuneiforms. Four vessels, each present in all of our specimens, provided distinct vascular territories to bone. A branch of the proximal lateral tarsal artery supplied a consistent vascular territory in the cuboid with an average of fifteen nutrient vessels. Similarly, a branch of the distal medial tarsal artery to the first cuneiform supplied an average of nine nutrient vessels superior to the tibialis anterior tendon insertion. A branch of the anterior lateral malleolar artery to the fibula supplied an average of seven nutrient vessels to the lateral malleolus. A branch of the distal lateral tarsal artery provided the midsection of the third cuneiform with an average of seven nutrient vessels. In the latex-injected specimens, harvesting of the vascularized pedicle bone grafts designed from these data demonstrated their anatomic plausibility and arcs of rotation. CONCLUSIONS: Four new rotational vascularized pedicle bone grafts have been identified in the foot and ankle. These grafts were present in all of our specimens, were well vascularized, had wide arcs of rotation, and were relatively easy to harvest.

Duke Scholars

Published In

J Bone Joint Surg Am

DOI

ISSN

0021-9355

Publication Date

September 2004

Volume

86

Issue

9

Start / End Page

1857 / 1873

Location

United States

Related Subject Headings

  • Tissue Donors
  • Tarsal Bones
  • Orthopedics
  • Orthopedic Procedures
  • Middle Aged
  • Male
  • Humans
  • Foot Bones
  • Female
  • Cadaver
 

Citation

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Chicago
ICMJE
MLA
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Gilbert, B. J., Horst, F., & Nunley, J. A. (2004). Potential donor rotational bone grafts using vascular territories in the foot and ankle. J Bone Joint Surg Am, 86(9), 1857–1873. https://doi.org/10.2106/00004623-200409000-00002
Gilbert, Brett J., Frank Horst, and James A. Nunley. “Potential donor rotational bone grafts using vascular territories in the foot and ankle.J Bone Joint Surg Am 86, no. 9 (September 2004): 1857–73. https://doi.org/10.2106/00004623-200409000-00002.
Gilbert BJ, Horst F, Nunley JA. Potential donor rotational bone grafts using vascular territories in the foot and ankle. J Bone Joint Surg Am. 2004 Sep;86(9):1857–73.
Gilbert, Brett J., et al. “Potential donor rotational bone grafts using vascular territories in the foot and ankle.J Bone Joint Surg Am, vol. 86, no. 9, Sept. 2004, pp. 1857–73. Pubmed, doi:10.2106/00004623-200409000-00002.
Gilbert BJ, Horst F, Nunley JA. Potential donor rotational bone grafts using vascular territories in the foot and ankle. J Bone Joint Surg Am. 2004 Sep;86(9):1857–1873.
Journal cover image

Published In

J Bone Joint Surg Am

DOI

ISSN

0021-9355

Publication Date

September 2004

Volume

86

Issue

9

Start / End Page

1857 / 1873

Location

United States

Related Subject Headings

  • Tissue Donors
  • Tarsal Bones
  • Orthopedics
  • Orthopedic Procedures
  • Middle Aged
  • Male
  • Humans
  • Foot Bones
  • Female
  • Cadaver