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ChinJTraumatol5(4):254–256ReferencesA–D315IndexAAccessorynerve,95Achillestendon,184,250Acromion,137Adipofascialflap,136Allentest,5,6Angiography,5,67,69,71,89,139,161,164–165,217,218,237,254,255,276,278Angularbranch,94,137,140Antebrachialcutaneousnerve,2Antebrachialfascia,3,20,34,46Antegradepedicledissection,255Anterior––intermuscularseptum,167,177,184,250––radialcollateralartery,49,52––rectussheath,110–117,122,124,130,257,258––superioriliacspine,68,72,111,116,189,193,216Anterolateralthighperforatorflap,5,70,71,277––advantages,217–218––anatomy,215–217––classification,213–214––comments,232––definition,214––development,214–215––disadvantages,217–218––flapdesign,219––completion,221,230–231––descendingbranch,220,226–228––fascialata,219,225,228––musclefibersseparation,219–220,225––perforatordissection,220,228––retrogradedissection,220,226––septo/myocutaneousperforatorandvariants,219,223––skinincision,219,224––skinislandcircumcision,220–221,229––skinpaddle,219,221,222,229––vascularpedicle,221,229––vascularsystem,219,222––freestyleapproach,215––indications,214–215––planning,220Anterolateralthigh/vastuslateralis––advantages,70––anatomy,67–70––development,66–67––disadvantages,70–71––flapraising––anterolateralthighmuscles,72,76––concomitantveinsandnerve,73,80––fasciaincision,72,78––flapdonorsite,74,84––intermuscularseptum,72–73,79,87––microvasculartransfer,74,85––muscleraising,73,82––myocutaneousflap,74,83,86––myocutaneousperforator,73,81––patientpositioning,279––perforators,79,80––planning,89––skinincision,72,77––skinpaddle,72,76,81,82––vascularpedicle,72,74,78,82,83,87––indications,66–67––myofascialflap––fasciaincision,74,87––intermuscularseptum,74,86––musclesegment,74,87,88––vastuslateralis,75,88––patientpositioning,72––preoperativemanagement,71Arcuateline,111,112,116,117,127,256Axilla,92,95,96,138,141Axillary––artery,49,94,136,137––vessel,94BBiceps––brachiimuscle,64––femorismuscle,72Biscapularflap,137Boneflap,140,160,188,190Brachial––artery,8,48,52,53,55––fascia,51––plexus,95Brachialismuscle,48,51,52,54,64Brachiaradialismuscle,2,3,6–8,10,16,21,25,37,39,51Breastreconstruction,110,111Burow'striangles,240CCaliber,2,4,24–26,92,94,97,110,112,138,160,161,163,214,218,221,239,253,254,275,277,280Cephalicvein,6,7,9,11,37,39,40,48–49––anddeepsystem,24,27,34––diameter,24––dissection,26,32––distalexposure,26,30––efficacyevaluation,25Chimericflap,70,215Chineseflap,2Choke––anastomoticvessels,213––artery,110,112,257Circumflex––femoralartery,66,67,71,74,89––ascendingbranch,188––descendingbranch,188,215,221––perforator,215––scapularartery,93,94,96,136,137,139––scapulavessel,96Circumflexscapularartery(CSA)––deepbranchidentification,140,146––subscapularismusclefibers,141,153Clavicle,95Comitantvein,49,53,73,74,80,136,137,184,189,220,255Commonperonealnerve,161,238,239Compartmentsyndrome,165,166Computedtomographicangiography,218,237,255,278Concomitantvein,93,235Cruralfascia,166,235,238,239Cubitalisinferiorartery,3Cutaneous––antebrachialnerve,8––branch,138,139,160,161––perforatingvessel,161,162––perforator,68–69,71,89,161,164,168,184––vessel,66–69,71,137DDeepcircumflexiliacartery(DCIA),112,188––anatomy,189,199––ascendingbranch,188––completion,193–194,206––dissection,192,200––iliaccrest,192,195––iliacusmuscle,193,204–205Deepfascia,214Deepflexorspace,239Deepinferiorepigastricartery(DIEA),110–114Deepinferiorepigastricarteryperforator(DIEAP),113–115,195––advantages,254–256––anatomy,253–254––comments,271––development,252–253316––Deepinferiorepigastricarteryperforator(DIEAP)(cont.
)––disadvantages,254–256––flapraising––abdomen,257,259,260––anteriorrectussheath,257,259––completion,258,270––DIEA,257,267––exposure,257,265,266––flapdesign,256–257––flapelevation,257,263––ligationandtransectionof,258,269––obliqueflapdesign,257,262––patientpositioning,256,257,262––pedicleextension,258,268––perforators,257,263––rectusmuscle,257,258,264,267––skinincision,257,262––skinpaddle,257,261––indications,252–253Deeppalmararch,3,10Deepradialvein,4,8,9Deepsuperiorepigastricartery(DSEA),112,254Deepsuperiorepigastricvessel,110,112,113,117Deltoid––insertion,49,51––muscle,51,54Descendingbranch,136,137,139,140DIEA.
SeeDeepinferiorepigastricartery(DIEA)DIEAP.
SeeDeepinferiorepigastricarteryperforator(DIEAP)Donor-site––complications,DIEAP,255––morbidity,36,275Doppler,68,71,89,139,158,163,166,218,237,238,256,257,271,278,279,291Dopplersonography,51,158,218Doubleanastomosestechnique,25Double-fibulatransplant,164Duplexscanning,255Dyeinjection,37,236,274,276EExtensormuscle,184Externaliliac––artery,112,113,189,192,258,271––muscle,192––vessel,194Externusobliquemuscle,189,191FFacial––nerve,92––skin,48,138Fascia,72–74,97––lata,68,72,216,219Fascialflap,2,50Fasciocutaneousflap,2–4,8,36Femoral––artery,110,189,192––nerve,67,69,73,210,220Femur,160Fibula,160,165,235,239––ankle,162––bone,236––flapraising––anteriorintermuscularseptum,167,177––deepflexorspace,167,174––distalosteotomy,167,176––flapraisingcompleted,169,182––flexorhallucislongusmuscle,167,168,174,180––flexorhallucismusclefibers,168,181––interosseousmembrane,168,177,178––laterallowerleg,musclesof,166,170––lateralmarginoffibula,166–167,173––lowerleg,arteriesof,166,170––osteocutaneousfibularflapanddonorsite,169,183––patientpositioning,166,171––perforatoridentification,166,172––peronealbranches,167,174––peronealvessels,167,168,175,178––proximalosteotomy,167,176––skinandfascia,166,172––skinpaddle,168,179,180––tibialisposteriormuscle,168,179––vascularpedicle,167,175––head,162,238Fibularflap,159,236––advantages,163––anatomy,160––comments,184––development,160––disadvantages,163––double-barreled,160––flapdesign,184––flapraising––flapdesign,166––patientpositioning,166––preoperativemanagement,165––indications,160––vascularpedicle,160Flapthinning,252Flexor––carpiradialis––muscle,3,7,8,10,20,26,34,39,46––tendon,5,7,9,14,21,26,36–39––carpiulnarismuscle,6,21––digitorummuscle,5,7,10––hallucislongusmuscle,167,168,240––hallucismuscle,235,236––pollicislongusmuscle,5,10,20,34,39,46Fluorescentperfusiontechnique,254Forearm––fascia,3,5–8,12,36–39––radial(see(Radialforearmflap))Fourflapzones,113,114GGastrocnemiusmuscle,274–277,280,281Glenohumeraljoint,139,140,158Gluteusmuscle,189,191,194––maximus,67––medius,193Groin,188HHernia,114Horizontalbranch,97,140Hypoglossalnerve,92IIleum,188Iliacartery,190Iliaccrest,70,93,164,189–194Iliaccrestboneflap––advantages,190–191––anatomy,189–190––comments,210––development,188–189––disadvantages,188–189––flapdesign,191,210––DCIA,dissectionof,192,200,201––distalosteotomy,193,206––internalobliquemuscle,192,197––musclesdetachment,193,203––musclestransection,193,202––myo-osseous,194,208,209––obliqueabdominalmuscles,193,203––residualmusclefibres,194,207––skinincision,inguinalligamentexposure,192,197,202––vascularpedicle,192,198––indications,188–189Iliacosteomyocutaneousflap,188Iliacus––fascia,189––muscle,189,190,192,193,210Iliohypogastricnerve,191Ilioinguinalnerve,191Iliosacraljoint,189,191Indirect––cutaneousvessel,212––perforator,213Inferior––epigastricartery,189,252––glutealartery,189Index317E–PInfraspinatusmuscle,139,140Inguinalligament,189,192Intercostal––artery,93,112,198––nerve,111Intermuscularseptum,51,66–68,71,72,74,79,86,87,89,167Internal––obliquemuscle,112,188–190,192–194,210––thoracicvessels,252Interosseous––artery,3,11,29,31,40––membrane,168,184––vessel,4Intramuscularcourse,216Ipsilateraldeepinferiorepigastricvessels,252Isolatedmuscleflap,188LLateral––circumflexfemoralartery,74––ascendingbranch,215––descendingbranch,215––obliquebranch,215––transversebranch,216––circumflexfemoralsystem,66––cutaneousfemoralnerve,69––epicondyle,49,51––femoralcutaneousnerve,190,192––intermuscularseptum,3,36–39,42––legperforatorflap,237––suralartery,274–276Lateralarmflap––advantages,50––anatomy,48–49,61––development,48––disadvantages,50––indications,48––patientpositioning,50––standardflapdesign––distalpedicleandseptumtransection,52,60––epiperiostealdetachment,61––fasciaincision,51,57––lateralintermuscularseptum,51,58––PCNA,49,52,53,62,63––pedicle,52,63––radialnerveexposure,52,59––septocutaneousperforators,51,59––septumfromhumerusbonedetachment,52,60––skinandfattytissueincision,51,56––skinpaddleposition,56––tricepsandseptumexposure,51,57––upperarmmuscles,54––vascularsystem,55Latissimusdorsiflap,138,140––advantages,94––anatomy,93–94––development,92––disadvantages,94–95––flapdesign––anteriormusclerim,96,99,101,102––elevatedflapattachedtoneurovascularpedicle,97,106––latissimusmuscle,97,103–105––musclefibers,completedivision,97,105––neurovascularpedicle,96,103––raisedflap,97,106––secondskinpaddle,96,100––serratusbranch,99,101,102––skinincision,96,101––skinpaddlecircumcision,97,104––thoracodorsalvessels,102––underminingmuscle,97,103––indications,92––lateralthoracicwall,98––patientpositioning,95––vascularsystem,99Latissimusmuscle,93,94,96,97,103–105Linea––alba,111,115,116––semilunaris,111–113,115–117,123,257Lipocutaneousflap,136Longpedicleperforatorflap,254MMagneticresonancetomography,161,164,165Malleolarjoint,166Medialsuralarteryperforatorflap––advantages,277–278––anatomy,275–277––development,274–275––disadvantages,277–278––flapraising––completion,281,289––deepfascia,279–280,284––directwoundclosure,281,290––lowerlegvessels,279,282––MSAdistaltoperforatorexposure,280–281,285,287––musclecuff,281,288,290––muscleincision,280,285––patientpositioning,279,284––pedicledissection,281,289––perforatorposition,279,283––perforator'sexitfrom,280,286––protectivecuffaroundperforator,280,286––raisedflap,281,290––skinincision,279–280,284––skinisland,281,288,289––indications,274–275Mixednerve,112Motor––branch,160––innervation,112,214––reinnervation,92Muscle-onlyflap,66,74,92,215Muscle-sparingflap-raisingtechnique,252Muscularflap,71Musculocutaneousperforator,215,274Myocutaneous––course,161,216––flap,67,71,74,75,83,86,92,110,111,113,117,215,274––perforator,190,223,225,275,276,280––rectusabdominisflap,110,111,113,115–117––skinvessel,70––vastuslateralisflap,67,68,70––vessel,94,274Myofascialflap,74–75,92Myo-osseousflap,192,194,196NNerveanastomosis,255Neurocutaneous––anastomosis,2––reinnervation,48Neurovascular––hilum,52,93,96,97––pedicle,52,74,96,97,103OOsseousflap,136Osteocutaneous––fibulaflap,160,162,234,235––flap,2,5,136–138,141,155–157,160,162,163,166,183,210,234–236––forearmflap,5––scapularflap,138,141Osteomyofascialflap,212Osteoseptocutaneousfibularflap,236Osteotomy––completion,193–194,206––lateralscapularrimandinferiorangle,141,152––scapula,140,151PPalmarislongusmuscle,2,7,8,10Parascapularflap,136–139Paraumbilicalperforator,110––flap,213Patella,66–68,72,219Pectoralismuscle,93Index318Pedicle––length,53––vascular,67–69,71–75,78,80,82,83,89Pelvicbone,191,192,194Perforatingvessel,94,110,113,161,163,189,213,235,254Perforator,68,70–72,79–81,86,89,166––myocutaneous,275,276,280––pedicle,227––length,236––periumbilical,112,113––septocutaneous,66,69,73Perfusionzone,113,254Periumbilicalperforator,112,113,257Peroneal––artery,160,161,163,236––flap,235––muscle,238,239,250––nerve,166––system,237––vessel,164,167,168,184,234,235Peroneus––flap,237––longusmuscle,166,277––muscle,162,235Popliteal––artery,160,274,275––crease,276–278––vessel,236Posterior––axillaryfold,93––calf,274,275,279––intermuscularseptum,161,166,167,238,240,250––PCNA,49,52,53,62,63––PCNF,49,51,52––PRCA,48,49,51,52,62––rectussheath,111,116,117,125,258,267,271––saphenousvein,185––tibialartery,160––triangle,136,138Posteriorcutaneousnerveofthearm(PCNA),49,52,53,62,63Posteriorcutaneousnerveoftheforearm(PCNF),49,51,52Posteriorradialcollateralartery(PRCA),48,49,51,52,62PRCA.
SeePosteriorradialcollateralartery(PRCA)Primaryflapthinning,69,217Profunda,215––brachiiartery,48,49,53,55––femorisartery,71,76,195,215,222Pubictubercle,210Pyramidalismuscle,111QQuadricepsfemorismuscle,67RRadial––artery,2–9,26––nerve,5,7,21,26,36,38,39,49–53,59,62,64,95––superficialradialnerve,7,14Radialforearmflap(RFF)––advantages,2,4––anatomy,3–4,20––cephalicvein(see(Cephalicvein))––development,2––disadvantages,4–6––flapraising––cephalicveininclusion,11––completionof,39,45––deepfascia,38,43––distalskinincision,13,38,41––distaltoproximal,26,31––donorsite,25,28––fasciaincision,13––flexorcarpiradialistendonexposure,14––flexorcarpiulnaris,13,26,29––flexormuscles,10––lateralintermuscularseptum,38,42––openingdeepfascialateraltoseptum,39,45––patientpositioning,6,25,28––pedicledissection,16,18,39,46––preoperativemanagement,6––radialflapmargin,39,44––radialskinincision,15––radialvessels,14,15,25,26,30,32,38–39,42,44––skinandwavyincision,17––skinflapelevation,38,42––standarddonorsite,36,40––standardflapdesign,11,12––subfascialdissection,13––subfascialflapelevation,16––superficialanddeepsystemforvenousdrainage,27,34––superficialnervebranches,26,30,31––superficialradialnerve,14,15––superficialveinexposure,17––suprafascialdissectionplane,38,41––ulnarskinincision,12,38,40––vasculararches,10––vascularpedicleexposure,18––venousreturnchecking,27,33––vesselsligation,26,30––indications,2–3Rectus––abdominismuscle,111,113,252,253––femorismuscle,66–68,72–74,79,89,216,232––lateralismuscle,214,216––muscle,68,72,73,75,219,252–254,256–258––sheath,252Rectusabdominisflap––advantages,113–115––anatomy,111–113––development,110–111––flapraising––anteriorrectussheath,116,117,122,124,130––caudaltransectionofmuscle,117,128––completion,117,130––deepepigastricvessels,115–116,120––distalmusclesegment,116,122––distalpole,116,120,121––fascialclosureofabdominalwall,117,131––flapmargin,116,121––lineasemilunaris,116,123––patientpositioning,115,119––pedicledissection,117,126––posteriorrectussheath,117,125––proximalpole,115,119––rectusmuscle,116–117,124––rectusmuscletransection,117,129––skinislandcircumscribing,116,123––TRAM,118––vascularhilum,117,125––vascularpedicle,117,127––indications,110–111Retrogradedissection,255Reverse-flowvenousanastomosis,255RFF.
SeeRadialforearmflap(RFF)Rib,92,115,190,191SSaphenousvein,185,240,274,275,278Sartoriusmuscle,193Scapula,137,139,158––branch,94,97Scapularflap,137––advantages,137–138––anatomy,136–137––comments104––development,136––disadvantages,138––flapdesign––bonefeedersidentification,140,148––deepbranchidentification,CSA,140,146––donor-sitedefect,141,157––inferiorangle,140,149––infraspinatusandteresminormuscles,140,148––medialpole,139,145––musclefiberscranially,transectionof,140,149Index319Q–V––osteocutaneousscapularflap,141,155–157––osteotomy,140,151–152––parascapularskinpaddle,140,147––scapularandparascapularskinpaddle,139,143––scapulardonorsite,139,142––scapularskinpaddle,139,145––subscapularismusclefibers,141,153––superficialbranchidentification,CSA,139,146––teresmajormuscle,140,150––teresminormuscle,141,154––vascularsystem,139,144––indications,136––patientpositioning,139––planning104Scapularvessel,94Segmentalnerve,111,255Sensateflap,8,49,50,160Sensoryinnervation,69Septocutaneous––anterolateralthighflap,68––branch,49––course,217––flap,36,39,48,51,213–214––perforator,36,51,57,59,66,69,73,162,213,217,234,236––skinvessel,70––vessels,36,39,162,184,215Septomyocutaneousperforator,162Septum,68,72,73Serratus––anteriormuscle,93,96,137––branch,93,94,96,137––muscle,93,96,97Shortpedicleperforatorflap,234,235,237Skin––graft,92,138––territory,163Small-caliberpedicle,110,254Soleus––flapdesign––commonperonealnerve,238,241––completion,240,248–249––fasciaseparation,239,245––muscleretraction,239,245––perforatorarteryandveins,240,247––perforatordissection,239–240,247––perforatorflapanddonorsite,238,242––peronealperforator,238,240––posteriorintermuscularseptum,239,245––proximallowerlegandstandardskinpaddle,238,243––skinandfascia,incisionof,240,248––skinincision,238–239,244––muscle,160,162,167,185,235,236,238,239,250––perforatorflap––advantages,237––anatomy,235–236––comments,250––disadvantages,238––flapdesign,238––flapraising,238––perforatorflap236-238––development,234––indications,234Source––artery,254––vessel,112,214,235,271Split-thicknessskingraft,5,36,37,50,71,165,169Subscapular––artery,93,94,136––muscle,93––system,139––vascularsystem,136––vessel,136–138Superchargingtechnique,111,252Superficial––branch,158––circumflexiliacartery,188––circumflexiliacvein,188––cutaneousvein,8––epigastricvascularsystem,110,256––epigastricvein,254––epigastricvessel,110,192––femoralartery,215––inferiorepigastricartery,112,255,256––palmararch,4––suralartery,274,275––vascularsystem,274––venoussystem,254Superior––epigastricartery,271––genicularartery,67––glutealartery,188Super-thinperforatorflap,252Supramicrosurgery,252Sural––cutaneousnerve,160––nerve,164–165,185TTensor––fasciaelataemuscle,66,193––muscle,72,191,194,219Teres––majormuscle,93,136,138–140,158––minormuscle,139,140,158––muscle,136,138Thigh,190Thinnedskinflap,215Thoracodorsal––artery,92–94,96,137,140,158––nerve,92,93,97Thoracolumbar––artery,189––fascia,93Tibia,160––anteriorartery,160––anteriorvessel,234––nerve,185––posteriorsystem,237––posteriorvessel,161,184,185,234Tibialisposterior––muscle,161,162,168,184,185––vessel,236Tourniquet,6,25,50,166,238,279,281,291TRAMflap,111,113–115,118Transversalis––fascia,112,189,192––muscle,210––vessel,111Transverse––branch,67,69,71,89,92,93,137,139––rectusabdominisflap,110,118,252––septocutaneousflap,136Transverserectusabdominisflap(TRAM),111,113–115,118,252–256Transversusmuscle,189–191,194Triangularspace,140,158Tricepsmuscle,48–54,61,136,142,158Trueperforatorflap,214,234,237,254Tuberculumpubicum,189UUlnar––artery,3,4,21––flap,3,21Ultra-thinflap,66Umbilicus,112,115,117,253,256,257,271VVascular––anatomy––anteriormusclerim,96,99––anterolateralthigh,219,222––lateralupperarmflap,51,55––osteocutaneousscapularflap,141,155––proximallowerleg,238,243––scapulardonorsite,139,142––fromsubscapularisartery,139,144––hilum,117,125,141––pedicle,2,4,6,8,9,18,21,49,51,52,64,67–69,71–73,117,127,136,140,163,192,234,275–277,281––territory,69,70,217,234,254––verticalbranch,92–94Vastoglutealmusclesling,67Index320Vastus––intermediusmuscle,67,73––lateralismuscle,66–74,89,214,216,218––flap,67,71––lateralisperforatorflap,214,255Veingraft,165Venosome,213Venousdrainage,4,6–9,21,26,27,34,39,49,112,191,240,254,278Vertebrae,93Verticalbranch,92–94ZZoneofsecurity,49Index