Topographical landmarks for lateral calcaneal artery sensate flap- A cadaveric study

Abstract

The lateral calcaneal artery (LCA) flap is used for treating skin defects of the foot. We aim to study the relationship between the LCA and the Sural Nerve (SN) with the lateral malleolus (LM) to delineate the topographical landmarks for identifying LCA and SN while designing the LCA flap. The foot was dissected to identify LCA and SN in 32 formalin-fixed lower limbs. The LCA and SN were identified and separated from the superficial fascia of the foot. Measurements such as the distance between the LCA and LM, SN and LM, and LCA and SN were taken in (a) horizontal plane, (b) 45º oblique plane passing, (c) vertical plane from the most prominent point on LM, including the luminal diameter of LCA.In the horizontal plane, the LCA and SN were present at a mean distance of 24.56±5.2 mm and 22.64±6.26 mm from the LM, respectively. In a 45° oblique plane, LCA and SN were present at a mean distance of 29.10±6.12 mm and 22.68±7.05 mm from the LM, respectively. In the vertical plane, the SN was present at a mean distance of 26.59± 8.87 mm from the LM.LCA was present in the horizontal plane and 45 oblique plane and was absent in the vertical plane in relation to LM; hence, the LCA flap should not extend beyond the 45 oblique plane, and the internal diameter of LCA should not be less than 1.02mm.