The applied anatomy and coordinate localization of the cutaneous branch chain in the anteromedial region of the lower leg

doi:10.13418/j.issn.1001-165x.2026.1.05

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Chinese Journal of Clinical Anatomy ›› 2026, Vol. 44 ›› Issue (1) : 28-34. DOI: 10.13418/j.issn.1001-165x.2026.1.05

The applied anatomy and coordinate localization of the cutaneous branch chain in the anteromedial region of the lower leg

Guo Zilong^1,3#, Xu Kangli^2#, Yu Hao⁴, Tan Ridong¹, Dai Huijie¹, Li Aoying¹, Shi Fuwen¹, Peng Tianhong¹*, Xie Wei¹*

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Abstract

Objective To provide an anatomical basis for the clinical application of the cutaneous branch chain flap in the anteromedial lower leg by clarifying its distribution and morphology, and establishing a standardized coordinate system for precise localization. Methods A total of 18 fresh adult cadaveric lower legs were used in the research. A total of 18 fresh adult lower extremity specimens were perfused with red latex plus lead oxide in the femoral artery on 6 sides and red latex in the femoral artery on 12 sides. Microdissection of 18 lateral lower leg specimens was performed to observe the cutaneous branches-chain in the anteromedial region of the lower leg, and the number, origin, course, and diameter of the perforator forming the cutaneous branch chain and having a diameter >0.2 mm were observed. The position of the dense point of cutaneous branch chain in the form of (±x, y) % was located by establishing the coordinate system of the lower leg. CT scan was performed in 6 specimens which were perfused with red latex and lead oxide, and three-dimensional reconstruction of the cutaneous branch chain of the anteromedial lower leg was performed. Results A total of 76 cutaneous perforators involved in forming cutaneous branch chain of the anteromedial lower leg in our study. The diameter of perforators at the deep fascia was (0.77±0.37) mm. Study demonstrated there were 5 cluster points of cutaneous clusters of cutaneous branch chain of the anteromedial lower leg. The total length of ring the popliteal fossa was (33.9±3.7) cm, and the total length of posterior midline of lower leg was (37.2±5.3) cm. Cluster points of cutaneous clusters of posterior tibial artery from the proximal end to the distal end was as follows, successively: (-24.0±2.4, 0.43±0.06) %, (-21.3±2.0, 0.52±0.04) %, (-17.6±5.2, 0.70±0.09) % and (-12.3±2.3, 0.90±0.05) %. The saphenous artery passed through the deep fascia in (-14.6±3.5，0.05±0.03) % and linked cutaneous branch chain of posterior tibial artery to form a cutaneous branches-chain vertical throughout anteromedial lower leg. The cutaneous branch chain was clearly visible after 3D reconstruction. The location of the penetration point of the perforator was standardized to have a smaller coefficient of variation than conventional anatomical positioning, and the comparison of the Y-axis coefficient of variation showed P<0.05. Conclusion The cutaneous branch chain is available to expand the range of skin flap and ensure safety for harvest of the flap. Standardizing location was more accurate and scientific than traditional anatomical location.

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Lower leg / / / / Flap / / / Cutaneous branch chain / / / Three-dimensional reconstruction

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Guo Zilong, Xu Kangli, Yu Hao, Tan Ridong, Dai Huijie, Li Aoying, Shi Fuwen, Peng Tianhong, Xie Wei. The applied anatomy and coordinate localization of the cutaneous branch chain in the anteromedial region of the lower leg[J]. Chinese Journal of Clinical Anatomy. 2026, 44(1): 28-34 https://doi.org/10.13418/j.issn.1001-165x.2026.1.05

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