Anatomic analysis of the vascular network and vascular pedicle of the tensor fascia lata flap (angiographic and cadaver study)

Abstract

Knowing the vascular network and properties of the vascular pedicle is of crucial importance for elevation of the tensor fascia lata (TFL) transpositional or free flap; therefore, the origin of the lateral circumflex femoral artery (LCFA), its diameter at the site of origin, the length of the vascular pedicle, the number of lateral branches, the number of terminal branches and the anastomosis of the LCFA ascending branch are of utmost importance for successful elevation and clinical application of this flap. The study was conducted on clinical (100 angiographic images of the femoral artery) and autopsy (48 preparations) material. The first part of the study comprised analysis of the angiographic images that were used to obtain the information on LCFA. The diameter of LCFA at its origin was measured to be 0.44 cm, while it was 0.33 cm at the origin of ascending branch. The mean value of the diameter at the bifurcation of the terminal branches of ascending branch (inside tensor fascia lata muscle) was 0.24 cm. It has been established that the vascular pedicle of the tensor fascia lata flap (ascending branch of LCFA) is anastomosed with the superior gluteal artery in all cases. Measurement of the tensor fascia lata muscle revealed an average length of 15.91 cm, width of 3.55 cm and thickness of 1.98 cm. Injection of colour-ink into the ascending branch LCFA that enters directly into the TFL muscle was used to measure the extent of the TFL flap vascularization and on the average, the TFL flap was 20.32 cm long and 16.57 cm wide while the surface was 17.52 cm3.