股内侧肌穿支皮瓣的解剖学基础与膝周创伤修复  

Anatomic basis of perforating branch flap of medial vastus muscle and the restoration of trauma around knees

作　　者：郑和平[1] 张发惠[1] 岳素琴[1] 

机构地区：[1]解放军南京军区福州总医院军区临床解剖学研究中心,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2007年第17期3382-3383,F0003,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：福建省自然科学基金重点资助项目(C0120001)~~

摘　　要：目的:探讨股内侧肌穿支皮瓣的解剖学特征,为临床膝周软组织缺损的修复提供一种新的术式。方法:实验于2005-01/10在解放军南京军区福州总医院军区临床解剖学研究中心实验室完成。30侧动脉内灌注红色乳胶的成人下肢标本由南京军区福州总医院军区临床解剖学研究中心提供。30侧成人下肢标本,以收肌结节、髌骨中点、腹股沟韧带中点为观测标志,重点解剖观测股内侧肌肌支的起源、走行、分支、分布及其远端吻合情况。一侧新鲜标本上,摹拟术式设计。结果:在股三角尖部自股动脉恒定发出的股内侧肌支,入肌门后在肌内沿肌束行向外下方,直至髌旁并与髌周动脉环相吻合。沿途除发出肌支营养股内侧肌外,还发出1～3支(77%为1支)、外径0.5～0.9mm肌皮穿支垂直穿过股内侧肌达深筋膜,并浅出至股内侧肌表面皮肤。皮瓣切取面积可达8.5cm×15.0cm。结论:可形成的以股内侧肌肌支-穿支逆行皮瓣转位可修复膝部软组织缺损。AIM： To probe into the anatomic features of perforating branch flap in the medial vastus muscle, so as to provide a new operation style for repairing the soft tissue defect in the periphery of knees. METHODS： The experiment was conducted in the Research Laboratory of Clinical Anatomy, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January to October 2005. Totally 30 adult lower limbs specimens perfused with red gelatin in the lateral arteries ware provided by the Research Center of Clinical Anatomy, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Thirty sides of adult cadaveric lower limbs specimens ware adopted, and the adductor tubercle, midpoint of whirbone and inguinal ligament ware taken as the observation sign. The origin, courser, branches, distribution and distal anastomosis of muscular branches in medial vastus muscle ware anatomized and observed. Mimic operation was performed on one side of fresh specimen. RESULTS： At the peak of femoral triangle, femoral artery permanently sent out medial vastus muscular branches and descended outwardly along the muscle bundle till lateral patella in the muscle after entering hilum of muscle, and anastomosed with artedal circle around whirbone. The muscular branches sent out nutrient medial vastus muscle along the way, besides that, it sent out 1-3 （1/77%） musculocutaneous perforating branches with the external diameter ranged 0.5-0.9 mm, and reached deep fascia perpendicularly through medial vastus muscle, and got to the skin superficial to medial vaatus muscle. The area of indsed flap was as large as 8.5 cm × 15.0 cm. CONCLUSION： Perforating branch-muscular branch of medial vastus muscle retrograde flap can be transposed to repair the soft tissue defect around knee.

关 键 词：膝损伤/外科学 外科皮瓣 皮肤移植 

分 类 号：R323.7[医药卫生—人体解剖和组织胚胎学]