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Background <p>The vascular perfusion of a split tibialis anterior muscle (TAM) flap has not been specifically investigated. This cadaveric study was performed to evaluate the anatomical reliability of a split TAM flap using thermographic assessment and contrast injection.</p> Methods <p>Five paired fresh-frozen cadaveric lower-extremity specimens were included. A split TAM flap was elevated using a design of longitudinal lateral split with a medial muscular hinge. Flap dimensions were recorded. Heated water was injected through the popliteal artery, followed by thermographic assessment using a thermal imaging camera. Subsequently, contrast medium was injected, and the number of intramuscular perforators supplying the split flap was evaluated.</p> Results <p>The mean flap dimension was 3 × 13.5&#xa0;cm² (range, 2.5–4 × 12–15&#xa0;cm²). Thermographic assessment demonstrated a mean temperature difference of 18.6&#xa0;°C between pre- and post-injection measurements. Following contrast injection, a mean of 4 intramuscular perforators was identified within each split TAM flap (range, 3–5).</p> Conclusion <p>The split tibialis anterior muscle flap demonstrates reliable vascular perfusion and represents a viable anatomical option for coverage of narrow anteromedial defects of the tibial shaft.</p>

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Reliability of the split tibialis anterior muscle flap for tibial shaft coverage: a cadaveric injection study

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Surasak Jitprapaikulsarn,
  • Jirachart Kraisarin,
  • Theerachai Apivatthakakul,
  • Pasin Lertvilai,
  • Pasit Sengpanich,
  • Arthit Gromprasit,
  • Kittipop Sitti,
  • Panachol Leangtanom

摘要

Background

The vascular perfusion of a split tibialis anterior muscle (TAM) flap has not been specifically investigated. This cadaveric study was performed to evaluate the anatomical reliability of a split TAM flap using thermographic assessment and contrast injection.

Methods

Five paired fresh-frozen cadaveric lower-extremity specimens were included. A split TAM flap was elevated using a design of longitudinal lateral split with a medial muscular hinge. Flap dimensions were recorded. Heated water was injected through the popliteal artery, followed by thermographic assessment using a thermal imaging camera. Subsequently, contrast medium was injected, and the number of intramuscular perforators supplying the split flap was evaluated.

Results

The mean flap dimension was 3 × 13.5 cm² (range, 2.5–4 × 12–15 cm²). Thermographic assessment demonstrated a mean temperature difference of 18.6 °C between pre- and post-injection measurements. Following contrast injection, a mean of 4 intramuscular perforators was identified within each split TAM flap (range, 3–5).

Conclusion

The split tibialis anterior muscle flap demonstrates reliable vascular perfusion and represents a viable anatomical option for coverage of narrow anteromedial defects of the tibial shaft.