胫后动脉中上段穿支走行特点与临床应用研究  

Distribution characteristics and clinical application of the perforators from upper middle section of the posterior tibial artery

作　　者：李扬[1] 周明武[2] 杨瑞甫[2] 朱杰[2] 宋力[2] 熊颖杰[2] 张迅[1] 周立[1] 

机构地区：[1]新乡医学院,河南新乡453003 [2]解放军第153中心医院全军创伤骨科中心,郑州450007

出　　处：《中国骨与关节外科》2015年第6期527-530,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:目前临床中缺乏对小腿内侧中上段胫后动脉穿支及其分支走行特点的解剖学研究。目的:探讨小腿内侧中上段胫后动脉穿支及其分支走行特点,为以穿支为蒂的游离或桥式组织瓣设计与切取提供解剖学基础。方法:收集2004年6月至2014年12月解放军第153中心医院保存的有关小腿内侧中上段胫后动脉穿支走行的临床病例解剖照片,并查阅相关患者的病例资料,同时对部分患者术后恢复情况进行跟踪随访。结果:小腿内侧中上段胫后动脉穿支走行有5种类型。依据穿支的不同类型,临床的应用结果:胫后动脉穿支皮瓣278例,以穿支为蒂双叶皮瓣5例,以穿支为蒂嵌合组织瓣17例,以健侧胫后动脉穿支为蒂的骨皮瓣桥式转移修复患侧胫骨骨缺损、骨髓炎2例。术后随访,均取得较为满意的治疗效果。结论:以胫后动脉穿支为蒂的游离或桥式组织瓣不会牺牲知名血管,对供区影响小,受区恢复好,是一类较为理想的修复方法。Background：There are few of anatomical studies reported on the distribution characteristics of the posterior tibial artery per-forators from upper middle section of the lower medial leg and their branches. Objective：To explore the distribution characteristics of the posterior tibial artery perforators from upper middle section of the lower medial leg and their branches so as to provide anatomical basis for design and harvest of free or bridge tissue flaps with the perforator pedicle. Methods：The cases related to the distribution of the posterior tibial artery perforators from upper middle section of the low-er medial leg were collected from June 2004 to December 2014. The clinical data of the patients were retrospectively ana-lyzed. The information of follow up was got from some of the patients. Results：There were five types of posterior tibial artery perforators from upper middle section of the lower medial leg. There were 278 cases of perforator flap based on the posterior tibial artery, 5 cases of bilobed skin flap based on the perforator of the posterior tibial artery, 17 cases of chimeric flap based on the perforator of the posterior tibial artery, 2 cases of bridge mode transfer of pedicle bone flap based on the perforator of the contralateral posterior tibial artery for repair of tibia defect and osteomyelitis. Good therapeutic effects were achieved in all flaps during follow up. Conclusions：The free or bridge tissue flaps with the posterior tibial artery perforator pedicle is a kind of ideal repair method without injuring well-known vessels. The donor area is small and recipient area is restored well.

关 键 词：小腿内侧 胫后动脉穿支 皮瓣移植 临床解剖 

分 类 号：R658.3[医药卫生—外科学]