大收肌腱复合组织瓣移植修复手部肌腱皮肤缺损术式解剖研究  

Anatomic study of transferring adductor magnus tendon combined tissue flap to repair the defects of hand skin and tendon

作　　者：黄东[1] 黄永军[2] 徐达传[3] 毛莉颖[1] 吴伟炽[1] 张翠琼[1] 

机构地区：[1]广东省第二人民医院创伤外科,广州510317 [2]广东医学院研究生学院,广东湛江524000 [3]南方医科大学临床解剖学研究所,广州510515

出　　处：《中国临床解剖学杂志》2008年第1期32-34,共3页Chinese Journal of Clinical Anatomy

基　　金：广东省自然科学基金(04005055)

摘　　要：目的:为带膝降动脉大收肌腱复合组织瓣修复手部肌腱伴皮肤(骨)缺损新术式提供应用解剖学基础。方法:在30侧经动脉灌注红色乳胶成人尸体下肢标本上对膝降动脉的起始、走行、分支和分布及大收肌腱的形态特点和血管分布进行了解剖观测。结果:①膝降动脉的主干长(1.22±0.48)cm,起点外径为(1.85±0.64)mm,主要分支有股内侧肌支、关节支、隐支。②关节支的主干长(5.2±1.12)cm;起点外径为(1.16±0.31)mm,分支营养大收肌腱和股骨内侧髁,并参与形成膝关节动脉网。③隐动脉起点外径(1.14±0.29)mm,分支营养缝匠肌下部、膝内侧上部皮肤,并参与膝关节动脉网形成。④大收肌肌腱质部长(9.4±2.1)cm,宽(12.2±0.28)mm,厚(1.92±0.64)mm。大收肌腱移行部长(4.5±0.71)cm,宽(20.0±2.7)mm,厚(5.8±2.1)mm。结论:以膝降动脉血管为蒂带其分支可形成大收肌腱骨肌皮复合组织瓣,吻合血管移植可修复不同类型的手部肌腱伴皮肌(骨)缺损,术式设计具有可行性,供区损伤小。Objective： To explore anatomic features of adductor magnus tendon combined tissue flap pedicled with descending genicular artery, and provide basis for repairing the defects of hand skin and tendon adopting this flap. Methods： The origin, course, branches and distribution of descending genicular artery, as well the morphologic features and blood supply of adductor magnus tendon were dissected and observed on 30 specimens of adult lower limb perfused with red latax, Results： The main trunk of descending genicular artery was about 1.22±0.48 cm in length and 1.85 ±0.64 mm in external diameter at its origin. It gave off medial femoral muscular branch, articular branch and saphenous branch. All these branches jointed the genicular arterial network. The articular branch of it distributed to adductor magnus and the periosterm of femoral internal condyle with the length of 5.2±1.12cm and external diameter of 1.16±0.31 mm at its origin. The saphenous artery supplied the lower part of sartorius and superior medial part of genicular skin with the length of 1.05± 0.34 cm and external diameter of 1.14±0.29 mm. The tendon of adductor magnus was about 9.4±2.1 cm in length, 12.2±0.28 mm in width and 1.92±0.64 mm in thickness. The juncture part between tendon and muscle belly of it was 4.5±0.71 cm in length, 20±2.7 mm in width and 5.8± 2.1 mm in thickness. Conclusions： Adductor magnus tendon possesses rich blood supply, therefore, it can be used to repair different types of hand defects.

关 键 词：大收肌腱 膝降动脉 移植修复 组织瓣 

分 类 号：R616.2[医药卫生—外科学] R622.2[医药卫生—临床医学]