Atlas Phẫu Thuật Vi Phẫu Mạch Máu (Atlas of Microvascular Surgery)

Posterior femoral cutaneous nerve, 131, 131f
gluteal thigh ap, 138, 138f
Posterior intercostal artery
revascularized costal bone graft and intercostal ap,
489, 489f
vascularized rib graft
incision, 490, 490f
intercostal space and rib exposure, 492, 492f
neurovascular bundle identi cation and dissection,
493, 493f
osteotomy and bony graft isolation, 494, 494f
serratus anterior muscle exposure, 491, 491f
Posterior interosseous artery (PIA)
interosseous forearm ap, 72–74, 72f–74f
reversed posterior interosseous ap, 83, 83f
surgical approach, 79, 79f
Posterior interosseous nerve, interosseous forearm ap,
75, 75f
Posterior tibial artery
bula resection
distal third exposure, 361, 361f
incision, 359, 359f
middle third exposure, 360, 360f
medial leg ap, 317, 317f
elevation, 320, 320f
medial m alleolus exposure site, 440–441, 440f–441f
medial plantar ap, 393, 393f
Princeps pollicis artery, deep palm ar arch origin
dorsal approach, 120–121, 120f–121f
palm ar approach, 117–119, 117f–119f
Profundus cubitalis vein, anatomy, 44, 44f
Proximal dissection, dorsalis pedis ap, 380, 380f
Proximal interphalangeal (PIP) joint
arterial anatomy, 431, 431f
free second toe transfer
disarticulation, osteotomy, and harvesting completion,
433, 433f
incision and skin island design, 431, 431f
neurovascular bundle dissection, 432, 432f
free toe/toe tissue transfers, 401–402
Proximal popliteal vessel exposure
lateral posterior leg ap, 341–342, 341f–342f
posterior leg ap, 339, 339f
Proximal tibial artery exposure, tibioperoneal trunk,
363–364, 363f–364f
R
Radial artery
bifurcation, 94–96, 94f–96f
deep palm ar arch, anatomy, 109–110, 109f, 112, 112f
distal portion, 99, 99f
forearm exposure, 97–99, 97f–99f
forearm ap
anatomy, 40, 41f
variations, 40, 42, 42f
proxim al portion, 98, 98f
skin territory of, 48, 48f
super cial palmar arch variations, 111, 111f
wrist variations, 42, 42f
Radial collateral artery, anatomy, 12, 12f
Radial forearm ap, 48, 48f
applications, 47
distal dissection, 49, 49f
ap design, 49, 49f
penile reconstruction, 55, 55f, 57, 57f
ulnar distal side dissection, 50, 50f
ulnar proxim al side dissection, 51, 51f
urethral creation, 56, 56f
Radial forearm osteocutaneous ap
bony segment proposal, 59, 59f
m edial bony segm ent exposure, 61, 61f
vascular bundle and bony segment ap elevation,
60, 60f
Radial forearm tendinocutaneous ap
completion, 64, 64f
proposed tendons, 63, 63f
Radial nerve, deep brachial artery exposure and, 37–38,
37f–38f
Radial side dissection, radial forearm ap, 52, 52f
Recipient site exposures
anterolateral thigh ap
adductor m agnus exposure, 261, 261f
anterior approach
com mon and super cial femoral arteries,
255–257, 255f–257f
deep femoral artery, 264, 264f
super cial fem oral artery, Hunter’s canal,
258–260, 258f–260f
deep fem oral artery
cross-sectional diagram , 270, 270f
identi cation, 269, 269f
fem oral artery identi cation, 262, 262f
fem oral nerve/vessel sheath exposure, 265–266,
265f–266f
posterior approach
deep fem oral artery, 267, 267f
super cial fem oral artery, 261, 261f
sciatic nerve, 268, 268f
super cial fem oral artery, cross-sectional diagram ,
263, 263f
artery identi cation, 439, 439f
axilla exposure, 28, 28f
axillary artery, 22–24, 22f
anatomic structure dissection and identi cation,
26, 26f
branch variations, 23, 23f
rst and second parts, 24, 24f
second and third parts, 27, 27f
brachial artery, 29–30
anatomic structure dissection and identi cation,
32, 32f
deep artery and radial nerve exposure, 37, 37f
m edial approach, 30, 30f
m iddle part exposure, 33, 33f
posterior approach, deep and proximal portions,
36, 36f
proxim al part, 30, 30f
retraction techniques, 38, 38f
carotid arterial system dissection, 659, 659f
carotid sheath, 658, 658f
INDEX 679

clavipectoral fascia, 25, 25f
deep inferior epigastric artery
dissection, 563, 563f
identi cation, 562, 562f
incision, 561, 561f
dissection and identi cation of anatomic structures,
29, 29f
dorsalis pedis artery, 438, 438f
extensor hallucis longus m uscle, 438, 438f
external carotid artery and branches
incision, 656, 656f
super cial structures, 657, 657f
medial plantar artery bifurcation with lateral plantar
artery
exposure techniques, 443, 443f
incision, 442, 442f
neurovascular bundle, 31, 31f
neurovascular sheath anatomy, 35, 35f
posterior leg ap
medial approach, distal portion, 334–336, 334f–336f
medial approach, m iddle portion, 331–333, 331f–333f
medial approach, proximal portion, 328–330,
328f–330f
posterior approach, 337–340, 337f–340f
posterior tibial artery, m edial m alleolus
arterial dissection, 441, 441f
incision, 440, 440f
radial artery, anatomic snuff box, 113–114,
113f–114f
radial/ulnar arteries bifurcation, 94, 94f
arterial exposure, 97–99, 97f–99f
brachial artery, 95, 95f
distal third exposure, 102, 102f
forearm exposure, 100, 100f
middle third exposure, 101, 101f
tracing of, 96, 96f
rectus muscle, 562, 562f
rectus sheath, 561, 561f
super cial structures, 34, 34f
superior gluteal artery, 151–153, 151f–153f
Rectus abdominis ap
anatomy, 518, 519f
applications, 521
blood supply, 518, 519f, 520, 520f
deep inferior epigastric vessels, m uscle ap
exposure, 522, 522f
harvesting completion, 524, 524f
incision, 522, 522f
vascular pedicle identi cation, 523, 523f
innervation, 520, 520f
modi ed lower TRAM ap
elevation and pedicle dissection, 531, 531f
muscle division, 530, 530f
myocutaneous ap
deep inferior epigastric artery, 527, 527f
donor site enhancem ent, 529, 529f
harvesting completion, 528, 528f
lower transverse rectus ap, elevation, 525f,
526, 526f
patterns of, 524–526, 525f
Rectus femoris ap
anatomy, 219, 219f
muscle ap
elevation, 221, 221f
incision, 220, 220f
pedicle identi cation, 220, 220f
musculocutaneous perforator veri cation,
241, 241f
myocutaneous ap
design, 222, 222f
elevation, 222, 222f
Rectus muscle, recipient site exposure, 562, 562f
Rectus sheath, recipient site exposure, 561, 561f
Retrograde deep venous system, forearm ap, 46, 46f
Revascularized anterior tibial ap, applications, 312
Revascularized costal bone graft and intercostal ap,
arterial anatomy, 490, 490f
Revascularized m edial leg aps, applications, 318
Reverse anterior tibial island ap
cross-sectional diagram, 316, 316f, 322, 322f
harvesting pattern, 316, 316f
Reversed island ap, applications, 47
Reversed island transfer, reversed radial forearm island ap,
58, 58f
Reversed peroneal ap
applications, 278
lateral leg skin ap, 287, 287f
Reversed posterior interosseous ap
completely raised ap, 85, 85f
design, 82, 82f
distal pedicle dissection, 84, 84f
hand transfer, 86, 86f
Reversed posterior interosseous osteocutaneous ap
bony exposure, 90, 90f
elevation and pedicle approach, 88, 88f
interosseous m em brane exposure, 89, 89f
proposed bony segm ent, 87, 87f
ulnar osteotomy, 91, 91f
Reversed radial forearm island ap, design, 58, 58f
Rib grafts
anterior costal osteocutaneous ap
design, 506, 506f
osteotomy and ap elevation, 508, 508f
vascular bundle identi cation, 507, 507f
anterior intercostal artery, 490, 490f
cartilage resection and vascular bundle identi cation,
504, 504f
incision and rib graft, 503, 503f
intercostal m uscle division, 505, 505f
intercostal space exposure, 504, 504f
intercostal spaces, 492, 492f
osteotomy and rib graft elevation, 505, 505f
posterior intercostal artery
incision, 490, 490f
intercostal space and rib exposure, 492, 492f
neurovascular bundle identi cation and dissection,
493, 493f
osteotomy and bony graft isolation, 494, 494f
serratus anterior m uscle exposure, 491, 491f
serratus anterior costo-osteomuscular ap, 487, 487f
680 INDEX

Rib-latissimus dorsi osteomyocutaneous ap
applications, 578
design and proposed rib, 593, 593f
dissection and osteotomy, 594, 594f
elevation, 595, 595f
S
Saphenous ap
anatomy, 305, 305f
applications, 306
harvesting technique, 307, 307f, 310, 310f
innervation, 306
proxim al super cial structures, 308, 308f
vascular approach, 309, 309f
Saphenous nerve, saphenous ap, 306
Saphenous vessels
dorsalis pedis ap, 373, 373f
saphenous ap approach to, 309, 309f
Sartorius m uscle, posterior leg ap, popliteal artery
exposure, 333, 333f
Scapular bone-latissim us dorsi osteom uscular ap
angular artery identi cation, 596, 596f
bony exposure, 598, 598f
muscle division and angular artery visualization,
597, 597f
osteotomy, 599, 599f
Scapular aps. See also Com bined scapular and latissimus
dorsi ap; Com bined scapular and parascapular
ap
anatomy, 605, 605f, 605t
applications, 606
axilla pedicle dissection, 611, 611f
design, 606–607, 606f
elevation, 609, 609f
osteocutaneous ap
design and bony segment, 613–614, 614f
elevation and bony exposure, 615, 615f
osteotomy, 616, 616f
triangular space dissection, 610, 610f
vascular emergence
lateral exposure, 607–608
medial exposure, 608, 608f
Sciatic nerve
gluteal thigh ap, 138, 138f
posterior exposure, 268, 268f
Sensate anterolateral thigh (ALT) ap
ap elevation, 254, 254f
sensory nerve identi cation,
253, 253f
Sensory nerve identi cation
anterolateral thigh ap, 236, 236f
latissimus dorsi ap, 577, 577f, 577t
sensate anterolateral thigh ap, 253, 253f
tensor fasciae latae ap, 213, 216, 216f
Septocutaneous perforators
anterior tibial ap, 312
anterolateral thigh ap, 235
medial leg ap, 317–318, 317f
identi cation, 319, 319f
Septofasciocutaneous ap
anterolateral approach, 239–240, 239f–240f
lateral arm ap, 13, 13f
Serratus anterior costo-osteom uscular ap
design and proposed rib, 487, 487f
vascular pedicle dissection, osteotomy, and elevation,
488, 488f
Serratus anterior ap. See also Composite serratus-latissim us
muscle ap
anatomy, 476, 476f
applications, 477
blood supply, 476
incision, 478, 478f
innvervation, 476
insertion detachm ent and harvesting, 482, 482f
muscle m obilization, 480, 480f
myocutaneous ap
design, 483, 483f
vascular pedicle dissection and elevation, 484, 484f
neurovascular bundle identi cation, 479, 479f
vascular pedicle dissection, 481, 481f
Serratus anterior m uscle, vascularized rib graft, 491, 491f
Skin aps
dorsalis pedis
design, 377, 377f
distal border dissection, 378, 378f
distal elevation, 379, 379f
elevation completion, 380, 380f
medial elevation and vascular bundle identi cation,
379, 379f
proxim al dissection, 380, 380f
rst web space (lower extremity)
design, 416, 416f
elevation technique, 418, 418f
plantar aspect dissection, 418, 418f
venous and arterial dissection, 417, 417f
Skin island design
free m etatarsophalangeal joint transfer, 434, 434f
free proximal interphalangeal joint transfer, 431, 431f
Soleus m uscle
bular osteomuscular ap transfer
cross-sectional diagram , 269f, 296
exposure techniques, 293, 293f
harvesting completion, 295, 295f
incision, 293, 293f
neurovascular structures, splitting and identi cation,
294, 294f
osteotomy, 295, 295f
tibioperoneal trunk
lateral approach, 351, 351f
medial exposure, 345, 345f
posterior exposure, 348, 348f
proxim al portion exposure, 364–365, 364f–365f
vascularized bula bone graft, 280, 280f
Split-thickness skin graft, saphenous ap, 306
Sternocostal segments, pectoralis major ap, 455–460
Stomach clamping, composite stom ach/omentum ap,
552, 552f
Stomach excision, composite stom ach/omentum ap,
553, 553f
INDEX 681

Stomach wall, composite stomach/om entum ap,
550, 550f
Submental artery, anatomy, 650, 650f
Submental ap
anatomy, 650, 650f
application, 651
elevation, 654, 654f
harvesting technique, 651, 651f
innervation, 650
pedicle dissection and ap completion, 655, 655f
upper border dissection, 653, 653f
vascular bundle identi cation, 652, 652f
venous drainage, 650, 650f
Subscapular vessels, latissimus dorsi ap, 575, 575f
Super cial cervical artery
anatomy, 644, 644f
identi cation, 647, 647f
variations, 645, 645f
Super cial cervical ap
applications, 646
arterial anatomy, 644, 644f
arterial variation, 645, 645f
artery identi cation, 647, 647f
dorsal elevation, 648, 648f
harvesting technique, 646, 646f
neurovascular pedicle dissection, 649, 649f
posterior cervical triangle innervation, 644, 644f
Super cial circum ex iliac artery (SCIA)
groin aps, 155–156, 155f–156f
iliac ap, identi cation, 165, 165f
iliofemoral ap
artery identi cation and dissection, 160, 160f
design, 158, 158f
elevation completion, 161, 161f
identi cation of SCIA, 163, 163f
lateral-to-m edial procedure, 159, 159f
m edial-to-lateral procedure, 162, 162f
osteocutaneous groin ap, 166, 166f
Super cial circum ex iliac vein (SCIV), groin aps,
156
Super cial femoral artery (SFA)
anterolateral thigh ap
anterior approach, 255, 255f
Hunter’s canal, 258–259, 258f–259f
posterior approach, 261, 261f
cross-sectional diagram, 263, 263f
dissection, 257, 257f
Super cial inferior epigastric artery ap
design, 172, 172f
elevation, 174, 174f
SIEV/SIEA identi cation, 173, 173f
Super cial inferior epigastric artery (SIEA)
groin aps, 155–156, 155f–156f
identi cation, 173, 173f
Super cial inferior epigastric vein (SIEV)
groin aps, 156
identi cation, 173, 173f
Super cial musculoaponeurotic system (SMAS)
temporocalvarial osteofascial ap, 639, 639f
temporoparietal fascia ap, 633, 633f
Super cial palm ar arch
incision and exposure sites, 122–123, 122f–123f
ulnar artery anatomy, 110, 110t
variations, 111, 111f
Super cial peroneal nerve, dorsalis pedis ap, 373, 373f
Super cial structures
carotid vessels, 657, 657f
posterior leg ap, popliteal fossa exposure, 338, 338f
recipient site exposure, 34, 34f
saphenous ap, 308, 308f
ulnar artery at wrist, 114–116, 114f–116f
Super cial temporal fascia, temporoparietal fascia ap,
633, 633f
Super cial veins
free big toe transfer, dissection, 404, 404f
free second toe transfer, dissection, 410, 410f
variations in, 45, 45f
Superior gluteal artery
gluteus maximus m uscle, 130, 130f
recipient site exposures, 151–153, 151f–153f
Superior gluteal artery perforator (S-GAP) ap
applications, 132
design and Doppler detection, 145, 145f
gluteus maximus m uscle anatomy, 130, 130f
Superior gluteal myocutaneous ap
applications, 132
design, 133, 133f
elevation completion, 135, 135f
upper lateral muscle edge exposure, 134, 134f
vascular pedicle approach, 134, 134f
Superior gluteal vessels, vascularized iliac bone grafts
gluteus medius approach, 141, 141f
incision, 140, 140f
interior ilium approach, 143, 143f
neurovascular bundle exposure, 142, 142f
osteotomy, 144, 144f
Superior lateral peroneal artery, anterior tibial ap,
311, 311f
Superior ulnar collateral artery, anatomy, 8–9, 8f
Suprafascial elevation, anterolateral thigh cutaneous ap,
243, 243f
Suture techniques, iliac bone grafts, 189–190, 189f–190f
T
Tarsal artery
dorsalis pedis ap, 373
extensor digitorum brevis ap, 389
Temporal artery, temporoparietal ap, 631–632, 631f
Temporal vein, temporoparietal ap, 631–632, 631f
Temporocalvarial osteofascial ap
elevation, 640, 640f
incision and proposed bone, 639, 639f
Temporoparietal ap
applications, 632
arterial anatomy, 631–632, 631f
fascia ap
elevation, 635, 635f
exposure techniques, 634, 634f
incision, 633, 633f
vascular pedicle dissection, 636, 636f
682 INDEX

Tendinocutaneous ap
applications, 47
dorsalis pedis, with extensor tendons
completion, 387, 387f
design, 385, 385f
lateral elevation, 386, 386f
vascular bundle, medial elevation, 385, 385f
“Tendon” transfer
composite anterolateral thigh ap
design, 246, 246f
ap completion, 247, 247f
lateral portion elevation, 247, 247f
medial portion elevation, 246, 246f
“tendon” formation, 248, 248f
composite groin ap, 168–171
aponeurosis elevation, 170, 170f
aponeurosis exposure, 169, 169f
design and incision, 168, 168f
Tensor fasciae latae (TFL) ap
anatomy, 212, 212f
applications, 213
blood supply, 213, 213t
chimeric ALT ap com bined with, 249, 249f
composite groin ap, tendon transfer, design and incision,
168, 168f
innervation, 213, 213t
myocutaneous ap
design, 214, 214f
distal elevation, 215, 215f
sensory nerve identi cation, 216, 216f
vascular pedicle dissection and elevation, 217, 217f
osteocutaneous groin ap, 167, 167f
osteomyocutaneous ap, elevation, 218, 218f
Teres major division, com bined scapular and latissimus
dorsi aps, 622, 622f
Thigh aps
anterolateral
anatomy, 234–236, 234f–236f
applications, 237
blood supply, 234–235, 234f–235f
chimeric ap
type 1, 249, 249f
type 2, 250, 250f
composite, with “tendon” transfer
design, 246, 246f
lateral portion elevation, 247, 247f
m edial portion elevation, 246, 246f
“tendon” form ation, 248, 248f
fasciocutaneous approach, 238, 238f, 241–242,
241f–242f
“ ow-through” ap, 251–252, 251f–252f
sensate ALT ap
ap elevation, 254, 254f
sensory nerve identi cation, 253, 253f
sensory innervation, 236, 236f
septofasciocutaneous ap, 239–240, 239f–240f
anterom edial
anatomy, 231, 231f
anterior elevation, 232, 232f
completion, 233, 233f
harvesting technique, 232, 232f
innervation, 231
vascular pedicle dissection, 233, 233f
lateral
anatomy, 226–227, 226f, 227t
anterior portion elevation, 228, 228f
harvesting technique, 228, 228f
innervation, 227
posterior portion elevation, 229, 229f
vascular pedicle dissection, 229–230, 229f–230f
m edial
anatomy, 223, 223f
elevation, 225, 225f
harvesting technique, 224, 224f
vascular pedicle identi cation, 224, 224f
Thoracic artery, lateral thoracic ap
accessory artery dissection, 511, 511f
dissection, lateral artery, 512, 512f
Thoracic ap
accessory lateral thoracic artery dissection, 511, 511f
applications, 510
arterial anatomy, 509, 509f
design and incision, 510, 510f
elevation, 514, 514f
innervation, 509
lateral thoracic artery dissection, 512, 512f
thoracodorsal artery dissection, 513, 513f
venous drainage, 509
Thoracoacromial artery
clavipectoral fascia exposure, 25, 25f
dissection and identi cation, 26, 26f
Thoracodorsal artery
anatomy, 571, 572f– 573f
lateral thoracic ap, dissection, 513, 513f
perforator ap (TAP)
anterior elevation and identi cation, 601, 601f
Doppler detection and ap design, 600, 600f
harvesting, 604, 604f
intramuscular dissection, 603, 603f
veri cation, 602, 602f
serratus anterior ap, 476
Thoracodorsal nerve, anatomy, 572f–573f, 576
Thoracodorsal neurovascular bundle, latissim us dorsi ap,
574, 574f
Thoracoumbilical ap, 525f, 531
lateral elevation, 532, 532f
m uscle detachm ent and ap completion, 534, 534f
vascular pedicle identi cation, 533, 533f
Tibial artery, tibioperoneal trunk, identi cation and
dissection, 346, 346f
Tibial ap
anatomy, 311, 311f
applications, 312
harvesting technique, 312–313, 312f–313f, 315, 315f
vascular bundle dissection, 314, 314f
Tibial nerve, tibioperoneal trunk, identi cation and
dissection, 349, 349f
Tibioperoneal trunk
anterior tibial artery arched segm ent, bula resection,
353–355, 353f–355f
INDEX 683

anterior tibial artery exposure
incision, 356, 356f
lower third exposure, 358, 358f
middle third exposure, 357, 357f
lateral approach
incision, 350, 350f
neurovascular structure identi cation and dissection,
352, 352f
soleus exposure, 351, 351f
medial approach
artery identi cation and dissection, 346, 346f
incision, 344, 344f
soleus exposure, 345, 345f
peroneal artery exposure
distal portion exposure, 366, 366f
incision, 362, 362f
lateral crural septum, proxim al portion, 363, 363f
proxim al portion exposure, 364–365, 364f–365f
posterior approach
incision, 347, 347f
soleus approach, 348, 348f
vascular bundle identi cation and dissection, 349, 349f
posterior tibial artery exposure
incision, 359, 359f
lower third exposure, 361, 361f
middle third exposure, 360, 360f
Toe tissue transfers
en bloc second and third toe transfers
donor closure, 437, 437f
harvesting completion, 437, 437f
vascular dissection, 436, 436f
free big toe transfer
dorsal/planter aspects, incisions, 403, 403f
FDMA dissection, 406, 406f
MTP joint disarticulation, and harvesting, 408, 408f
plantar side dissection, 408, 408f
super cial vein dissection, 404, 404f
vascular pedicle identi cation, 405, 405f, 407, 407f
free second toe transfer
arterial anatomy, 411, 411f
rst dorsal m edial artery dissection, 412, 412f
incision, 409, 409f
MTP joint disarticulation and harvesting, 415, 415f
pedicle dissection, 413, 413f
plantar side dissection, 414, 414f
super cial vein dissection, 410, 410f
free toe transfers
applications, 401–402
arterial anatomy, 399, 399f
variations, 400, 400f, 400t
Transversalis sutures, iliac bone grafts, 189, 189f
Transverse rectus abdom inis myocutaneous (TRAM) ap
applications, 521
deep inferior epigastric artery identi cation, 527, 527f
donor site enhancem ent, 529, 529f
elevation, 526
harvesting completion, 528, 528f
inferior epigastric vessels, 526
lower ap, 525f, 526
modi ed ap
elevation and pedicle dissection, 531, 531f
m uscle division, 530, 530f
Triangular space
parascapular ap, 612, 612f
scapular ap, dissection, 610, 610f
Tube prefabrication, composite stom ach/om entum ap,
554, 554f
U
Ulnar artery
bifurcation, 94–96, 94f–96f
deep palm ar arch system, 112, 112f
forearm ap
anatomy, 40–41, 41f
variations, 40, 43, 43f
recipient site exposure, 100–102, 100f–102f
super cial palmar arch system , 110–112, 110t, 111f–112f
at wrist, 114–116, 114f–116f
Ulnar distal dissection, radial forearm ap, 50, 50f
Ulnar forearm ap
applications, 47
design, 67, 67f
distal and proxim al neurovascular dissection, 68, 68f
elevation accomplishment, 71, 71f
radial aspect dissection, 70, 70f
ulnar aspect dissection, 69, 69f
Ulnar nerve, brachial artery exposure, 32, 32f
Ulnar osteotomy, reversed posterior interosseous
osteocutaneous ap, 91, 91f
Ulnar portion elevation, posterior interosseous ap,
80, 80f
Ulnar proxim al dissection, radial forearm ap, 51, 51f
Ultrasonic Doppler owm eter testing, radial forearm ap
design, 49
Urethral creation, radial forearm ap, 56, 56f
V
Vascular emergence
scapular ap, lateral exposure, 607, 607f
scapular ap, m edial exposure, 608, 608f
Vascularized bone grafts
bula
applications, 278
cross-sectional diagram, 284, 284f
extraperiosteal exposure, bula lateral aspect, 280, 280f
incision, 279, 279f
osteotomy, 281, 281f
peroneal vessel identi cation, 282, 282f
posterior crural septum approach, 279, 279f
vascular bundle dissection and harvesting completion,
283, 283f
iliac grafts
anatomy, 181, 181f, 181t
applications, 132
deep circum ex iliac artery anatomy, 179–180,
179f–180f, 179t
applications, 181
dissection, 184, 184f
donor closure, 189, 189f
684 INDEX

incision, 182, 182f
inner lip osteotomy, 188, 188f
inner space, DCIA dissection, 185, 185f
middle/outer layer suturing, 190, 190f
outer ilium exposure, 186, 186f
pedicle approach, 183, 183f
whole iliac crest osteotomy, 187, 187f
gluteus m axim us m uscle anatomy, 130, 130f
gluteus m edius approach, 141, 141f
groin aps, 157
inner ilium approach, 143, 143f
neurovascular bundle exposure, 142, 142f
osteotomy, 144, 144f
superior gluteal vessel approach, 140, 140f
Vascularized joint transfer
arterial anatomy, PIP/MTP joints, 431, 431f
en bloc second and third toe transfer
harvesting and donor closure, 437, 437f
vascular dissection, 436, 436f
free MTP joint transfer, second toe
incision and skin island design, 434, 434f
osteotomy and harvesting completion, 435, 435f
vascular system dissection, 434, 434f
free PIP joint transfer, second toe
disarticulation, osteotomy, and harvesting completion,
433, 433f
incision and skin island design, 431, 431f
neurovascular bundle dissection, 432, 432f
Vascularized rib grafts
anterior intercostal artery
cartilage resection and vascular bundle identi cation,
504, 504f
incision and rib graft, 503, 503f
intercostal m uscle division, 505, 505f
intercostal space exposure, 504, 504f
osteotomy and rib graft elevation, 505, 505f
posterior intercostal artery
incision, 490, 490f
intercostal space and rib exposure, 492, 492f
neurovascular bundle identi cation and dissection,
493, 493f
osteotomy and bony graft isolation, 494, 494f
serratus anterior m uscle exposure, 491, 491f
Vascular pedicle
ALT perforator fasciocutaneous ap, 242, 242f
anterior costal osteocutaneous ap, identi cation,
507, 507f
anterior tibial ap, dissection, 314, 314f
anterolateral septofasciocutaneous ap, 240, 240f
anteromedial thigh ap, 233, 233f
dorsalis pedis ap
applications, 376
m edial elevation and identi cation, 379, 379f
dorsalis pedis tendinocutaneous ap, medial elevation,
385, 385f
dorsal wrist ap, 92, 92f
en bloc second and third toe transfers, dissection, 436, 436f
free big toe transfer
dissection, 407, 407f
identi cation, 405, 405f
free second toe transfer, m etatarsophalangeal joint,
434, 434f
gracilis m uscle ap, 206, 206f
gracilis myocutaneous ap, 210, 210f
lateral arm ap
anterior approach, 16, 16f
posterior approach, 15, 15f
lateral intercostal skin ap, dissection and elevation,
498, 498f
lateral thigh ap, 229–230, 229f–230f
lateral thoracic ap, creation of, 510
m edial arm ap
anterior harvesting approach, 10, 10f
posterior harvesting approach, 10, 10f
m edial thigh ap, 224, 224f
posterior arm ap, 20, 20f
posterior leg ap, dissection, 327, 327f
radial forearm osteocutaneous ap, 60, 60f
rectus abdom inis m uscle ap, identi cation, 523, 523f
serratus anterior costo-osteomuscular ap, dissection,
488, 488f
serratus anterior ap, dissection, 481, 481f
serratus anterior myocutaneous ap, dissection,
484, 484f
subm ental ap, identi cation, 652, 652f
superior gluteal myocutaneous ap, 134, 134f
temporoparietal fascia ap, dissection, 636, 636f
tensor fasciae latae (TFL) ap, 217, 217f
thoracoum bilical ap, identi cation, 533, 533f
tibioperoneal trunk, identi cation and dissection, 349,
349f
vascularized bula bone graft, dissection of, 283, 283f
vascularized rib graft, posterior intercostal artery,
identi cation, 504, 504f
vastus lateralis myocutaneous ap, 245, 245f
Vastus lateralis m uscle
composite anterolateral thigh ap, “tendon” transfer,
lateral portion elevation, 247, 247f
m usculocutaneous perforator veri cation, 241, 241f
myocutaneous ap, 245, 245f
Vastus m edialis m uscle, popliteal artery identi cation,
330, 330f
Venae com itantes
gracilis ap, 203, 203f
lateral thoracic ap, 509
radial artery, 44, 44f
retrograde deep venous system, 46, 46f
Venous dissection
rst web space skin aps (lower extrem ity), 417, 417f
hybrid radial forearm ap, 65, 65f
Venous drainage. See also Arterial anatomy; Blood supply
deep inferior epigastric perforator ap, 537, 537f
dorsalis pedis ap, 373, 373f
forearm, 44, 44f
groin aps, 156
interosseous forearm ap, 76
lateral thoracic ap, 509, 509f
subm ental ap, 650
vascularized iliac bone grafts, deep circum ex iliac artery
and, 179, 179t
INDEX 685

W
“Winging” scapula, serratus anterior ap, 477
Wrap-around ap (lower extrem ity)
design, 419, 419f
harvesting completion, 421, 421f
modi ed wrap
design, 422, 422f
donor closure, 429, 429f
rst web dissection, 425, 425f
interphalangeal joint, ap elevation,
427, 427f
m edial ap elevation, distal phalanx, 426, 426f
neurovascular pedicle dissection, dorsum of foot,
423, 423f
phalanges osteotomy, 428, 428f
plantar dissection, 242f, 424
prefabricated ap, 429, 429f
neurovascular pedicle dissection, dorsal elevation,
420, 420f
plantar dissection, 421, 421f
Wrist
radial artery variations, 42, 42f
ulnar artery, 114–116, 114f–116f
686 INDEX