缝匠肌深层肌间筋膜蒂髂骨瓣转位的应用解剖和临床应用  

Applied anatomy for transposition of iliac bone flaps pedicled with sartorius muscular fascia and intermuscular septum vessel and its clinical application

作　　者：陈书连[1] 王永奎[2] 郑作超 史欣良[4] 刘志成[1] 

机构地区：[1]河南省人民医院骨科,郑州450003 [2]郑州大学医学院解剖学教研室,郑州450052 [3]郑州市上街区人民医院骨科,郑州450041 [4]河南科技大学医学院解剖学教研室,河南洛阳471000

出　　处：《中国临床解剖学杂志》2004年第5期555-557,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为带缝匠肌深层肌间隙筋膜蒂的髂前上下嵴间骨瓣转位治疗股骨颈部病变提供解剖学依据。方法:在28侧经动脉灌注红色乳胶的下肢标本上,对缝匠肌、阔筋膜张肌和股直肌三者之间的肌间筋膜的血管分布和走行进行观察。并进行12例手术应用。结果:所需的肌间筋膜位于髂前上棘下10 cm的范围内,由缝匠肌、阔筋膜张肌和股直肌三者之间的肌间的近侧段所组成。该肌间行走的主要血管:来自旋股外侧动脉的升支及其分支-髂嵴支、臀中肌支、髂前下棘支和来自旋髂浅动脉与旋股外侧动脉的缝匠肌节段性血管,上述血管相互吻合形成丰富的肌间筋膜血管网。采用缝匠肌深面肌间筋膜蒂的髂前上下棘间骨瓣移植,髂嵴支和缝匠肌的节段性血管可保留,肌筋膜蒂的长度可以达到6-8 cm。结论:采用带缝匠肌深层肌间筋膜蒂的髂前上下棘间骨瓣转位移植治疗股骨颈部病变,方法简便,是治疗股骨颈部病变中需要植骨时可选用的简便方法。Objective: To provide anatomic basis for transposition of iliac bone flaps between anterior superior iliac spine and anterior inferior iliac spine pedicled with sartorius muscular fascia and intermuscular septum vessels. Methods: On 28 adult cadavers perfused with red emulsion, the sartorius muscular fascia and intermuscular septum vessels among the sartorius muscle, the femoris rectus muscle and the tensor muscle of fascia lata were observed. 12 cases were treated with this method. Results: The sartorius muscular fascia and intermuscular septum needed in clinical operation were limited the point about 10cm descended from the spina iliaca anterior superior. The vessels of the sartorius muscular fascia and the iliac crest branches of ascending r鈓us of lateral femoral circumflex vessels were the supplied vessels. The pedicle length of the sartorius muscular fascia and intermuscular septum was 6-8 cm. Conclusion: The operative method is effective and convenient for treating the lesion of the neck of femur.

关 键 词：缝匠肌 肌间筋膜 骨瓣 髂前上棘 股骨颈 

分 类 号：R616.2[医药卫生—外科学]