A Clinicoanatomical Study of Perforators of the Posterior Tibial Artery in Distal One-third of the Leg

Introduction: The posterior tibial artery (PTA) is the terminal branch of the popliteal artery. PTA flap has gained widespread clinical importance in reconstructive surgeries. Perforator flap procedures will be complicated without thorough knowledge of the anatomy of the underlying vasculature. Various areas of the body can be used to develop different types of flaps that can be used effectively to increase the survival of the flaps and thereby minimize morbidity and the quality of life the patients. Materials and Methods: The study was conducted on 29 lower limbs of 15 adult fresh frozen cadavers. There were 9 males and 6 females who voluntarily donated their bodies to the Department of Anatomy, King George’s Medical University UP, Lucknow. Latex mixed with red paint was injected into the femoral artery. We measured the diameter, length, and distance of the perforator of PTA from the medial tibial border (MTB) and medial malleolus (MM) in the distal one-third of the leg. Results: The mean distance of all septocutaneous perforators from MTB and MM was 25.6 ± 2.4 mm and 72.6 ± 27.1 mm, respectively. The mean length and diameter of the perforator were 16.6 ± 4.4 mm and 0.64 ± 0.11 mm, respectively. Conclusion: The best flaps can be harvested from the distal one-third of the leg as it has a large piece of the skin and a long pedicle. Hence, for designing these flaps, the knowledge regarding location, type, length and caliber of the perforator as well as the area of skin it is supplied by it is mandatory.