带监测皮岛的胫前动脉穿支骨膜瓣设计的显微解剖学研究  

The design of the perforator periosteal flap with monitoring flap pedicled with the anterior tibial artery perforator

作　　者：江钦文[1] 黄东[2] 吴伟炽[2] 葛军委[1] 黄国英[2] 

机构地区：[1]广东医学院研究生学院,广东湛江524000 [2]广东省第二人民医院创伤外科,广州510317

出　　处：《中国临床解剖学杂志》2011年第2期152-154,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的为胫前动脉穿支骨膜瓣临床应用提供解剖学基础。方法在18侧成人下肢标本上解剖观测了胫骨外侧骨膜血管来源、走行、分支分布及吻合情况。结果 （1）胫骨上段有胫前返动脉骨膜支1-3支和胫前动脉骨膜支,分布于胫骨外侧髁前面及外侧面骨膜,中、下段为来自胫前动脉的肌骨膜支和直接骨膜支5~7支,分布于胫骨外侧骨膜。骨膜支蒂长（1.2±0.3）cm,外径（0.7±0.2）mm,伴行静脉两条。（2）胫前动脉骨膜支呈节段性分布,于胫骨前缘分出升支、降支和皮支。相邻升、降支彼此吻合成血管链,反复分支形成骨膜动脉网营养骨膜。皮支穿深筋膜入皮,供养小腿前外侧皮肤。结论可设计以胫前动脉穿支为蒂的带监测皮岛的穿支骨膜瓣,通过吻合血管游离移植为治疗骨不连、骨缺损提供一种新术式。Objective To provide anatomic basis for clinical application of the anterior tibial artery perforator periosteal flap.Methods On 18 adult cadaveric lower limb specimens,the origins,courses,branches,distributions and anastomosis of the lateral tibial periosteal vessels were microdissected.Results 1.On the upper section of tibia,1-3 periosteal branches from the anterior tibial recurrent artery and the anterior tibial artery located in the front and external periosteum of the tibia lateral condyle,and on the middle and lower sections,the anterior tibial artery gave off 5-7 muscular periosteal branches and direct periosteal branches to the external periosteum of the tibia.the periosteal branches were accompanied by two veins,with a length of its pedicle of（1.2±0.3） cm and a diameter of（0.7±0.2）mm.2.Periosteal branches from the anterior tibial artery showed a segmental distribution and gave out ascending,descending and cutaneous branches at the anterior border of the tibia.The adjacent descending and ascending branches dovetailed into vascular chain and periosteal vessel net.The cutaneous branches supplied the anterolateral skin of the crus.Conclusions The perforator periosteal flap with monitoring flap pedicled with the anterior tibial artery perforator could be designed for the treatment of nonunion and defect of bone through free transplantation.

关 键 词：穿支骨膜瓣 监测皮岛 胫前动脉 移植 显微解剖 

分 类 号：R616.2[医药卫生—外科学] R323.72[医药卫生—临床医学]