GIẢI PHẪU MẠCH MÁU CHI DƯỚI TRÊN PHIM CẮT LỚP VI TÍNH: CÁC BIẾN THỂ VÀ ỨNG DỤNG TRONG TẠO HÌNH BẰNG VẠT XƯƠNG MÁC

Abstract

Backgrounds: Currently, the free fibula flap has become one of the most commonly used materials in reconstructing bone and soft tissue defects. The fibula flap is nourished by the peroneal artery, so a thorough understanding of the vascular anatomy and its variants is important. Patients and methods: This study was conducted on 40 patients who underwent maxillofacial reconstruction with the free fibula flap from May 2023 to August 2024. The age of the patients ranged from 13 to 72 years old, with 55% of them being male and 55% being female. The parameters recorded on preoperative computed tomography angiography of the lower limbs included fibula length, bone and vascular abnormalities, length of truncus tibiofibularis, diameter of truncus tibiofibularis, and diameter of peroneal artery. Results: The mean age of the study cohort was 43.12 ± 17.10 (ranging from 13 to 72). There was no difference in mean age between men and women (p = 0.600). Gender differences were observed in fibula length (p < 0.0001) and diameter of truncus tibiofibularis (p = 0.012). There was no difference between the two legs in fibula length and vascular parameters such as length and diameter of truncus tibiofibularis and diameter of peroneal artery. The frequency of vascular abnormalities in the two legs was similar, and there was no case of type III-C branching, which is an absolute contraindication of fibula flap harvest. Conclusion: CT angiography of the lower limbs with contrast should be routinely performed before fibula flap harvest to detect early vascular abnormalities that may be contraindications of this technique.