逆行外踝上筋膜皮瓣修复前足缺损的解剖学基础

目的 为改良逆行外踝上筋膜皮瓣的临床应用提供解剖学依据。方法 对30侧新鲜下肢标本进行显微解剖，观测腓动脉终末穿支降支及其交通支的起始、长度、外径、走行、分支及毗邻关系等。结果 外踝上动脉降支在外踝下与外踝前动脉、跗外侧动脉、跟外侧动脉、足底外侧动脉之间均有广泛的吻合支存在，且吻合血管恒定，外径在1mm左右，可以此设计逆行外踝上筋膜皮瓣的旋转轴点以扩大皮瓣的应用范围。结论 改良逆行外踝上筋膜皮瓣血运可靠，质地佳，血管蒂长，可逆行修复前足的软组织缺损。

Aantomical basis of the reversed lateral supramalleolar fasciocutaneous flap on repairing tissue defection of forefoot

Objective To provide applied anatomic basis for the clinical application of the modified reversed lateral supramalleolar fasciocutaneous flap. Methods The anatomic study was carried out on 30 fresh cadaveric legs. The origin,pathway,and branches,calibers and lengths of blood pedicels were observed. Results There were many constant branches which connected the descending branch of perforating branch of the peroneal artery with lateral anterior malleolar artery,lateral tarsal artery,lateral plantar artery and peroneal artery below lateral malleous. Their calibers were about 1mm. The peronel artery can be designed for the rotatory point of reversed lateral supramalleolar fasciocutaneous flap in order to amplify its applied scope. Conclusions The modified reversed lateral supramalleolar fasciocutaneous flap is the reliable flap with long pedicle and good texture in repairing tissue defection of forefoot.