腓浅神经营养血管远端蒂皮瓣感觉重建的解剖学基础  

Anatomic basis of sensation restoration of distally based island flap pedicled with nutrient vessels of superficial peroneal nerve

作　　者：郑和平[1] 汪华侨[2] 张发惠[1] 

机构地区：[1]南京军区福州总医院军区骨科研究所,福建省福州市350025 [2]中山大学中山医学院人体解剖学教研室

出　　处：《中华显微外科杂志》2008年第6期435-437,I0007,共4页Chinese Journal of Microsurgery

摘　　要：目的为腓浅神经营养血管远端蒂皮瓣感觉功能重建提供解剖学依据。方法在40侧常规防腐的成人下肢标本上，解剖观测小腿外侧部感觉神经的来源、走行及分布规律。1例标本摹拟手术设计。结果①腓肠外侧皮神经在腓骨头尖平面上方约7cm处自腓总神经发出．向下随腓总神经行一短程后穿出胭筋膜至小腿外面，沿途发出1—3个终支，分布于小腿后外侧Ⅰ、Ⅱ区的皮肤。②腓浅神经在腓骨头下1．9cm处起于腓总神经．先于腓骨长肌与腓骨之间向下向前行．继降于腓骨长肌与腓骨短肌之间并分支供应两肌，其主干（纯感觉支）径直下行于腓骨短肌与小腿前肌间隔之间，在小腿外侧Ⅱ、Ⅲ区交界处穿出深筋膜至皮下组织中分为足背内侧、中间皮神经，分布于小腿外侧Ⅲ区和足背的皮肤。结论通过腓肠外侧皮神经主干与受区感觉神经分支吻合，可重建腓浅神经营养血管远端蒂皮瓣的感觉功能。Objective To provide anatomic basis for sensation restoration of distally based island flap pedicled with nutrient vessels of superficial peroneal nerve by use of lateral sural cutaneous nerve. Methods The origin, course and distribution rule of lateral part sensory nerve of leg were dissected and observed in 40 antiseptieized adult cadaveric limbs. Results ①Lateral sural cutaneous nerve originated from common peroneal nerve 7cm above apex of fibular head, descended short distance along common peroneal nerve, then passed through popliteal fascia to facies lateralis cruris, along the way it sent out 1-3 terminal branches, which distributed over the skin of Ⅰ , Ⅱ area in the posterior lateral leg. ②Superficial peroneal nerve originated from common peroneal nerve 1.9cm below apex of fibular head, descended forward between peroneus longus and fibula, then descended between peroneus longus and peroneus brevis, and sent out branches to the two muscles. The nerve bole （pure sensory nerve branch） descended straight between peroneus brevis and anterior crural intermuscular septum, at the juncture between ]I , m area in facies lateralis cruris, passed through deep fascia to subcutaneous tissue, then sent out medial dorsal cutaneous nerve of foot and intermediate dorsal cutaneous nerve of foot, which distributed over the skin of dorsum of foot and Ill area in facies lateralis cruris. Conclusion It may be available in sensation restoration of distally based island flap pedicled with nutrient vessels of superficial peroneal nerve through anastomosis of lateral sural cutaneous nerve bole with sensory nervous ramification of recipient site.

关 键 词：外科皮瓣 腓浅神经 腓肠外侧皮神经 显微外科 

分 类 号：R686[医药卫生—骨科学]