Applied anatomy of iliac flap with pedicled deep iliac circumflex artery in adults

Objective To understand the relationship between the origin and length of deep circumflex iliac artery （DCIA） and with ilium, aiming to provide anatomical basis for the clinical application of internal fixation of pedicled DCIA flap in the treatment of femoral neck fracture in young adults. Methods Twelve DCIAs were dissected in 6 formalin-fixed adult cadavers （3 male and 3 female）, and the origin and length of DCIA and the relationship with ilium were systematically observed.The size, origin and length of iliac flap and the relationship with ilium of 1 female case were measured and recorded intraoperatively. Results A total of 12 DCIAs were observed in 6 adult specimens, all of which originated from the external iliac artery. The external diameter of the origin of DCIA was （2.26±0.21） mm. The length of the iliac segment of the iliac flap was （5.89±0.33） cm. The length of the iliac segment was （1.34±0.29） cm. The total length of DCIA was （7.23±0.66） cm. The vertical distance between DCIA and ilium was （0.90±0.20） cm. No statistical significance was observed between the male and female cases or between the left and right sides （all P > 0.05）. The size of iliac bone of 1 female case was intraoperatively measured as 4.0 cm× 0.8 cm. The vertical distance between DCIA and anterior superior iliac spine （ASIS） was 1.1 cm. The vertical distance between distal DCIA and ilium was 1.0 cm. Finally, it was communicated with the blood vessel of abdominal cavity at a distance of 1.5 cm from ASIS, where the external diameter of DCIA was 0.6 mm. Finally, the length of vascular pedicle of pedicled iliac flap was 7.8 cm. Conclusions A long vascular pedicle with an appropriate external vessel diameter can be obtained via DCIA. Resection of the bone flap above ASIS can not only make the vessel pedicle reach the appropriate length, but also ensure the effective blood supply of the iliac flap.