隐神经营养血管复合组织瓣的解剖学研究  

An anatomic study of composite tissue flap with saphenous nerve and nutrient vessels

作　　者：陶圣祥[1] 喻爱喜[1] 郑晓晖[1] 余国荣[1] 邓凯[1] 张奕[1] 张建华[1] 

机构地区：[1]武汉大学中南医院显微骨科、武汉大学医学院显微外科研究所,430071

出　　处：《中华创伤骨科杂志》2007年第3期248-250,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨顺行及远端蒂隐神经营养血管复合组织瓣的解剖学依据。方法对30侧成人下肢灌注标本进行解剖学研究，观测小腿内侧区浅层中血管、神经的分支、分布及吻合情况。结果胫后动脉的肌间隙支中有1～2支较粗大的肌皮支，2支者起始处动脉外径为（1．1±0．3）mm，由该肌皮支发出2-3个肌支，外径为（0．5±0．2）mm，穿入比目鱼肌肌质中，与肌内的血管网吻合；骨皮支2支，起始处外径为（1．2±0．3）mm，均发出1～2支骨膜支分布于胫骨骨膜；同时，比目鱼肌中有3～4支肌皮穿支穿出肌质，外径为（0．3±0．2）mm，出肌质后在筋膜内与隐神经营养血管链吻合。结论隐神经营养血管皮瓣可携带比目鱼肌内侧部肌质、胫骨（膜），应用该组织瓣进行转位术修复特殊类型的小腿及踝足部软组织缺损操作简便，是值得推荐的良好供区。Objective To investigate the anatomy of antegrade and distally pedicled composite tissue flaps with saphenous nerve and nutrient vessels. Methods Distribution and confluence of the blood vessels, nerves and their branches lying in the superficial layer of the medial crural region were observed on 30 specimens of adult cadaver lower limb which had been injected with red staining latex. Results One or two main myocutaneous branches of posterior tibial artery ran out of the spatium intermusculare, with an external diameter of about （1.1 ± 0. 3） mm. They gave off 2 to 3 muscular branches with a mean caliber of （0. 5 ± 0. 2） mm which penetrated into the soleus muscle where they joined the intramuscular vessels. There were two bone-cutaneous branches calibrated （ 1.2 ± 0.3 ） mm at the origin which gave out 1 to 2 tibial periost branches. Meanwhile, there were 3 to 4 myocutaneous perforating branches which ran out of the soleus muscle, with a mean caliber of （0. 3 ± 0. 2） mm, and joined the nutrient vessels of the saphenous nerve in fascia. Conclusions Saphenous neuro-cutaneous flaps can be harvested along with partial medial part of the soleus muscle and tibial periost so that they can be designed to repair special soft tissue defects in leg, ankle and foot. The transposition of the flaps is simple and their donor site is recommendable.

关 键 词：隐神经 外科皮瓣 修复 解剖学 

分 类 号：R686[医药卫生—骨科学]