腓深神经和足背动脉关系在足背复合组织瓣中的意义  

Anatomic significance of the relationship between the deep peroneal nerve and dorsalis pedis artery on the dorsalis pedis compound flaps

作　　者：刘海昌[1] 黄显军 夏春林[1] 陆志方[1] 宋占锋[1] 

机构地区：[1]苏州大学医学部博习临床解剖学研究所暨解剖学教研室,江苏苏州215123 [2]浙江省荣军医院显微外科,浙江嘉兴314000

出　　处：《中国临床解剖学杂志》2008年第6期604-606,611,共4页Chinese Journal of Clinical Anatomy

基　　金：浙江省嘉兴市科技局资助项目(2006AY2055)

摘　　要：目的:探讨腓深神经和足背动脉在足背部的位置关系,为带神经血管蒂的足背复合组织瓣的切取提供解剖基础。方法:选用经福尔马林固定的足踝部完好的下肢68侧,逐层解剖,在踝上显露腓深神经和胫前动脉向远端追踪解剖;定量描述腓深神经分支点到足背动脉和踝间线的位置关系,并对神经和动脉的位置关系进行分型。结果:腓深神经分支点集中在踝间线上(9.34±3.4)mm至踝间线下(14.00±5.28)mm;动脉内侧3.46mm至动脉外侧3.32mm这个范围之内,58.0%(36侧)位于动脉的前上。神经分支后,外侧支位于浅面,与深面的跗外侧动脉平行进入短伸肌;内侧支与动脉伴行,根据神经与动脉关系可分为5型:Ⅰ型,神经伴行于动脉的内侧(50.0%);Ⅱ型,神经位于动脉的外侧(11.8%);Ⅲ型,神经和动脉彼此交叉(26.5%);Ⅳ型,动脉自神经内侧支的分支间穿出(2.9%);Ⅴ型:内侧支缺如(8.8%)。结论:腓深神经和足背动脉在足背部位置关系的解剖特点对足背复合组织皮瓣的切取有指导意义。Objective： To investigate anatomic relationship between the deep peroneal nerve and dorsalis pedis artery on the dorsum of foot, and provide basis for the preparation of the dorsalis pedis compound flap containing neurovascular pedicle. Methods： 34 formalin- fixed adult cadavers （68 specimens of lower limbs） without trauma or damage were dissected layer by layer. The deep peroneal nerve and the anterior tibial artery were exposed on the superior of the ankle, and traced toward their distal end, and then, anatomic relationship among the bifurcations of the deep peroneal nerve, the line between lateral and medial malleolus and dorsalis pedis artery were described and typed. Results： The bifurcations of deep peroneal nerve were observed usually from （9.34±3.40）mmabove to （ 14.00 ±5.28 ）mm below the ankle interstitial line, and medial 3.46mm.to lateral 3.32mm of the artery, with 58.0% （36 specimens）at the anterosuperior side of the artery. The lateral terminal branch of the nerve located at the superficial surface of the artery,paralleling with lateral tarsal artery and reached musculus extensor digitorum hrevis. The medial terminal branches ran along the dorsalis pedis artery. According to the relationship between nerve and artery, 5 types were determined： Type Ⅰ, The nerve was medial to the artery （50.0%）; Type Ⅱ, The nerve was lateral to the artery （11.8%）; Type Ⅲ, The nerve and the artery overlapped with each other （26.5%）; Type Ⅳ, the artery passed through the branches of medial nerve branches （2.9%）; Type Ⅴ, the medial terminal branch of the deep peroneal nerve was absent （8.8%）. Conclusions： It is helpful for obtaining ideal dorsalis pedis compound flaps including neurovascular pedicle after understanding the anatomic relationship between deep peroneal nerve and dorsalis pedis artery.

关 键 词：腓深神经 足背动脉 足背复合组织瓣 应用解剖 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]