Anatomical basis of a pedicled cuboid bone graft based on the lateral tarsal artery for talar avascular necrosis.

Abstract

Vascularized pedicled bone-grafting from the cuboid to the talus provides low donor site morbidity and satisfactory outcomes in patients with early-stage talar avascular necrosis. We investigated the anatomy of the rotational vascularized pedicled bone graft from the cuboid. 15 embalmed cadaver specimens were perfused with red latex via the popliteal artery. The lateral malleolus was dissected. The course of the lateral tarsal artery and the vascular territory in the cuboid supplied by the lateral tarsal artery were observed. Vessel diameters were measured. The course of the lateral tarsal artery to the cuboid was consistent, and a vascularized pedicle of the lateral tarsal artery was present in all specimens. Mean diameter of the lateral tarsal artery was 1.40 ± 0.12mm (range 1.67-1.25). Mean length of the vascularized pedicle was 67.15 ± 3.18mm (range 62.43-74.36). The pedicle bone graft was long enough to reach the bony border of both the lateral and medial malleolus. A vascularized pedicled cuboid bone graft based on the lateral tarsal artery has clinical utility for early-stage talar avascular necrosis.