带旋股外侧血管升支髂嵴支和髂前下棘支双骨膜瓣的应用解剖  

Applied anatomy for transposition of two periosteal flaps pedicled with iliac crest and anterior inferior iliac branches of ascending rarus of lateral femoral circumflex vessel

作　　者：赵德伟[1] 王卫明[1] 陈要武[2] 马岩[2] 杨磊[1] 郭哲[1] 张朝阳[1] 荆拓[3] 卢建民[1] 

机构地区：[1]大连医科大学附属第四医院骨科,辽宁大连116001 [2]大连医科大学解剖学教研室,辽宁大连116001 [3]沈阳市第七人民医院,辽宁沈阳110001

出　　处：《中国临床解剖学杂志》2003年第3期211-213,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为带旋股外侧血管升支髂嵴支和髂前下棘支双髂骨膜瓣转位治疗儿童Pethes病提供解剖学依据。方法 :在 3 2例经动脉灌注红色乳胶的下肢标本上 ,对旋股外侧血管升支的髂棘支及髂前下棘支的走行、分支、分布进行观察 ,设计带旋股外侧血管升支髂嵴支和髂前下棘支双骨膜瓣转移治疗儿童Perthes病的手术方法。结果 :旋股外侧血管升支髂前下棘支长度 ( 5 .3± 1.0 )cm ,距离升支起点 ( 2 .9±1.1)cm ,起点外径 ( 1.2± 0 .3 )mm ,可切取髂前下棘 2 .0cm× 2 .0cm带血管蒂的骨膜瓣 ,联合升支髂棘支骨膜瓣转移到儿童股骨头骺板上下病灶区。结论 :该方法简便、有效、实用 ,是一种治疗Perthes病的有效方法。Objective: To provide an effective and convenient microsurgical method to treat ischemic necrosis of femoral head in children (Perthes Disease). Methods: The distributions and courses of the two periosteal flaps pedicled with iliac crest and anterior inferior iliac branches of ascending rarus of lateral femoral circumflex vessel were observed on 32 adult cadavers which were perfused with red emulsion. The blood supplies of the two bone flaps on two fresh cadavers perfused with ink were observed and the operation for treatment of Perthes Disease was designed. Results: The length of anterior inferior iliac branches of lateral femoral circumflex vessel was 5.3±1.0 cm, the external diameter of the origin was 1.2±0.3 mm, and the distance to the origin of the ascending branch was 2.9±1.1 cm. The available area of periosteal flap was 2.0 cm×2.0 cm. These two periosteal flaps combed with could be transported to the area around the epiphysis of femoral head. Conclusion: The operative method is an effective and convenient method for the treatment of Perthes Disease.

关 键 词：骨膜瓣 缺血性坏死 显微外科 解剖 

分 类 号：R616.2[医药卫生—外科学]