带血供腓骨下段骨瓣移位融合踝关节的解剖与临床  

An Anatomical and Clinical Study on Role of Vascularized Distal 1/4 Fibular Flap in Ankle Fusion

作　　者：陈振光[1] 余国荣[1] 喻爱喜[1] 谭金海[1] 郑晓晖[1] 

机构地区：[1]武汉大学中南医院骨科,湖北武汉430071

出　　处：《医学新知》2009年第5期261-263,共3页New Medicine

摘　　要：目的探讨带血供腓骨下段骨瓣移位融合踝关节的可行性、手术方法和临床效果。方法在73根干燥、完整的成人腓骨标本，28侧经动脉灌注红色乳胶成人下肢标本和5侧新鲜截肢标本上观测腓骨下段的骨性结构及其营养血管。对12例施术病案进行临床分析。结果腓骨下段的内侧面较为平坦，与胫、距骨形成侧向相贴的构建，可就地取材，就近植骨。所携带的营养血管主要有腓动脉的弓形动脉和外踝后动脉。全部病例均经1～2年随访，术后3～4个月，关节均获骨性愈合，无感染现象。结论经踝关节外侧入路，以带血供的腓骨下段骨瓣植骨行踝关节或四关节融合具有良好疗效。Objective To explore the feasibility, operative method and efficacy of vascularized distal fibular flap in ankle fusion. Methods The morphologic features and nutrient vessels of distal fibula were observed on specimens of 73 dry fibulas, 28 artery-red-latex-perfused adult lower limbs and 5 fresh amputated lower extremities. Altogether 12 clinical cases were involved. Results The smooth and fiat medial surface of distal fibula was articulated with tibia and talus. In the operation of ankle fusion, the consecutive fibula could be served as a convenient flap to graft the tibia and talus. The flap was mainly supplied by arcuate arteries of peroneal artery and posterior lateral malleolar artery. All the clinical cases of ankle fusion were followed-up for over one year. These patients got satisfactory results of bone union without infection. Conclusion The vascularized distal fibular flap for ankle fusion or four-joint fusion with trans-fibular approach is a convenient and reliable method.

关 键 词：腓骨下段 腓动脉的弓状动脉 踝关节融合 植骨 

分 类 号：R687.34[医药卫生—骨科学]