Vascularized proximal fibular epiphyseal transfer has been used to treat the loss of the growth plate in a growing child. Various vessels have been used in the past to support this transfer, but more recently the most successful were the anterior tibial artery and the inferior lateral genicular artery. Although this has been demonstrated clinically, a comparison of the vascular distribution of both vessels was not done. This study aims at comparing the fibular vascular territory of both vessels.
Methods:
Six pairs of lower extremities were used for this study, a total of 12 specimens. Each pair was collected from the same donor to match the 2 groups. Through a posterior midline incision, the popliteal artery was identified at the popliteal fossa. In the right specimens, the anterior tibial artery was cannulated, and in the left specimens, the inferior lateral genicular artery was cannulated. Specimens were injected with ward’s red latex. After 24 hours at 4°C, the fibula was extracted with the surrounding periosteum and a cuff of soft tissues, then the length of perfusion was measured as the distal-most presence of the latex from the proximal tip of the fibula.
Results:
Of the 6 pairs of lower extremities, 3 were males and 3 were females. Average age of the donors was 86.7 years, and all of them were Caucasians. Average length of the fibula was 37.1cm. In the 6 right specimens, the average length of perfusion of the anterior tibial artery was 37.1cm, which was equal to the whole length of the fibula in all specimens. In the 6 left specimens, the average length of perfusion of the inferior lateral genicular artery was 5.9cm (range from 4.3 to 10.1cm).
Conclusion:
The anterior tibial artery can supply the whole fibular length, whilst the inferior lateral genicular artery can supply only the proximal portion. Although both arteries can be used as the pedicle for proximal fibular transfer, the inferior lateral genicular artery can perfuse only a limited length of the adjacent fibular shaft. This becomes relevant when a longer length of the fibular shaft should be included with the transfer.