以内踝前血管为蒂胫骨远端内侧骨膜瓣移位术的应用解剖  

Applied anatomy of the transposition of the penosteal flap pedicled with the medial anterior malleolus vessel on the distal base of the medial tibia

作　　者：张发惠[1] 陈振光[2] 郑和平[1] 谢昀[2] 陶圣祥[2] 

机构地区：[1]南京军区福州总医院军区临床解剖学研究中心,福州350025 [2]武汉大学中南医院显微外科,武汉430071

出　　处：《中国临床解剖学杂志》2004年第6期573-575,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为内踝前血管胫骨远端内侧骨膜瓣移位术提供解剖学依据.方法:30侧经动脉灌注红乳胶成年下肢标本,观测内踝前动脉的来源、走行、分支分布、邻近吻合及胫骨远端内侧面的骨膜血管.结果:内踝前动脉起于胫前动脉或足背动脉,紧邻胫骨前肌腱内侧行向前内,在楔骨内缘与足底内侧动脉浅支,或跗内侧动脉后行支形成吻合.动脉沿途发出3～6支外径为0.3～1.0 mm的内踝骨膜支,分布内踝区骨膜,并与其它来源的胫骨远端内侧面骨膜动脉相吻合.结论:以内踝前血管为蒂的胫骨远端内侧骨膜瓣,顺行移位可修复胫骨远端骨不连,顺行或逆行移位可用于修复距骨颈骨折和距骨体缺血性坏死.Objective: To provide anatomic basis for transposition of the periosteal flap pedicled with the medial anterior malleolus vessel on the distal base of the medial tibia. Methods: The origin, course, branches distribution, and anastomosis of medial anterior malleolus artery and periosteal vessels on the distal base of the medial tibia were observed on 30 adult cadaveric foot specimens. Results: Medial anterior malleolus artery along medial sides of tendon sheath of anterior tibial muscle was anastomosed with the superficial branch of medial plantar artery or the medial taesal artery in the medial cuneiform bone. The arteries sent out 3~6 pieces periosteum branches with diameter 0.3-1.0mm, which distributed to the periosteal of medial malleolus and was anastomosed with the periosteal artery on the distal base of the medial tibia. Conclusions: It is feasible to repair fracture of medial malleolus, neck of talus fracture and ischemic necrosis of talus body by achieving the transposition of periosteal flap pedicled with the medial anterior malleolus vessel on the medial of tibia distally based.

关 键 词：距骨 内踝前动脉 跗内侧动脉 胫骨远端 骨膜辩 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学] R616.2[医药卫生—基础医学]