肌间隙血管为蒂小腿内侧皮瓣的应用解剖及临床应用  

Applied anatomy of the lower medial leg fasciocutaneous flap pedicled with the intermuscular branch of the posterior tibial artery and its clinical significance

作　　者：劳杰[1] 熊良俭[2] 顾玉东[1] 梁秉中[2] 赵新[1] 

机构地区：[1]复旦大学附属华山医院手外科,上海200040 [2]香港中文大学矫形与外科学系

出　　处：《中国临床解剖学杂志》2002年第1期71-72,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为胫后动脉的肌间隙分支为蒂小腿内侧皮瓣移植提供解剖学基础。方法 :选用新鲜尸体60侧经胫后动脉起始部进行墨汁注射 ,以内踝至胫骨平台将小腿等分成A、B、C、D 4个区段 ,在手术放大镜下进行解剖观察血管分支长度、口径、类型。结果 :B区胫后动脉肌间隙分支长 (4 .5± 0 .6)cm ,外径 (1.7± 0 .2 )mm。C区胫后动脉肌间隙分支长 (4 .0± 0 .6)cm ,外径 (1.5± 0 .3 )mm。其余A、D区分支细、短。结论 :以胫后动脉的肌间隙支为蒂小腿内侧皮瓣血管蒂较长 ,口径适合显微外科的吻合要求 ,可用于游离移植修复 ;临床修复手皮肤缺损 6例 ,皮瓣全部成活。Objective: To provide anatomical basis for the application of the lower medial leg fasciocutaneous flap pedicled with the intermuscular branch of the posterior tibial artery.Methods: The lower leg was divided into four average regions: A,B,C and D regions.The lengths, diameters and branching patterns of the intermuscular branches of posterior tibial artery were observed under microscope on 60 sides lower limbs perfused with black ink at the origin of posterior tibial arteries. Result: The length and diameter of the intermuscular branch of posterior tibial artery averaged 4.5±0.6 cm and 1.7±0.2 mm in region B, and averaged 4.0±0.6 cm and 1.5±0.3 mm in region C.The branches in region A and D were shorter and finer. Conclusion: The lower medial leg fasciocutaneous flap pedicled with the intermuscular branch of the posterior tibial artery (in region B and C) has a long vessel pedicle and the diameter of the vesel is big enough for microsurgical operation. This flap has been used to resurface wounds of the hand on six cases, all the flaps survived completely.

关 键 词：肌间隙血管 小腿内侧 外科皮瓣 胫后动脉 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学] R622.1[医药卫生—基础医学]