跖骨的动脉分布

通过动脉灌注研究了９０侧不同年龄（婴儿至８７岁）尸体跖骨的血液供应。分布于跖骨的动脉来自滋养动脉、骨膜动脉、骺－干骺动脉和假骺动脉。滋养动脉的近、远侧支供应皮质的内２／３￣３／４；骨膜动脉发出少量小支进入骨皮质，供应皮质的外１／３￣１／４；骺－干骺动脉呈轮辐状发自续于跖骨干的骨膜动脉浅丛，供应第１跖骨底和第２￣５跖骨头；假骺动脉从骺－干骺动脉发出后，穿过非关节面区，供应第２￣５跖骨底和第１跖骨头。     

小儿胫骨皮质的血液供应

本文采用血管灌注、显微镜观察骨切片的方法,研究了40侧小儿胫骨皮质的血液供应。骨皮质血管主要由毛细血管和静脉窦组成。二者粗细不等,相互吻合成网。滋养动脉是骨皮质的主要血供来源,供应骨皮质深层的3/4左右。骨皮质浅层由骨膜动脉供应。两组血供来源在骨皮质内有广泛吻合。小儿胫骨皮质血管由骨干中部向两侧干骺端呈放射状分布。骨皮质的静脉血主要经皮质窦回流到骨髓静脉内。     

切除骨膜后骨变化的实验性研究

用杂种狗10只,随机分三组,在麻醉和无菌条件下,行大面积胫骨骨膜剥离术,并作了切断滋养动脉与保留滋养动脉的对照。实验动物分期杀死取材,用解剖法、X线法和组织学法进行观察。实验说明大面积切除骨外膜和破坏滋养动脉后,骨的血供可由干骺血管系统和剩余部份的骨膜血管代偿,骨质不致坏死,而有反应性新生。骨膜的再生力很强,再生的骨膜同样具有成骨作用。实验提示,胫骨骨外膜可以作为吻合血管大面积移植骨膜的新供区     

兔胫骨骨折愈合微血管重建的研究

目的 为澄清骨折愈合微血管重建意见的分歧。方法 实验用兔２４只,４只用于正常胫骨血管观察,另２０只制成骨折模型,术后分别按３,８,１８,２８,４２天处死,观察微血管重建,结果：（１）微血管数量生长可分为三个时期,初期（约１周）骨折部位无或有少新生血管,中期（２－４周）血管形成达最高峰;后期（５周以后）血管数量减少并逐渐转为正常形成。（２）侧支循环的建立是多源的,包括从骨膜动脉到骨痂;从骺－干骺动脉     

家兔下颌骨血管构筑的研究

对12只家兔下颌骨的血管进行造影、铸型、墨汁灌注及组织切片观察，发现下列结果：（1）下颌骨体的颊侧粘骨膜由面动脉分支供应，舌侧粘骨膜由颏下动脉和舌下动脉的分支共同供应。下颌支表面的粘骨膜由局部肌动脉供应，这些肌动脉分别来自面动脉、颞浅动脉、上颌动脉、下牙槽动脉的分支。（2）下颌骨的体接受来自其粘骨膜动脉的供血，但主要是接受下牙槽动脉供血；下颌支接受局部肌动脉和粘骨膜动脉的供血。（3）下颌骨皮质内和骨孔内的小动脉、小静脉和毛细血管，它们向内与骨内牙周膜和骨髓腔内的血管有丰富的交通；向外与骨外粘骨膜的血管有丰富的交通。这些血供特点为下颌骨截骨术后移动骨块能从粘骨膜蒂得到血运代偿提供了形态基础。     

胫骨远端骨折的治疗进展

在解剖学上，胫骨按照Carr—Sobba—Bear胫骨分区法，被分为6个区。分别是Ⅰ区（胫骨头区）位于膝关节周围，多为松质骨；Ⅱ区（胫骨结节区）为皮质骨与松质骨交界区，骨膜厚；Ⅲ区（近侧中段骨干区）为皮质骨；Ⅳ区（中段骨干区）为皮质骨，仅单一的髓内血供；Ⅴ区（远侧中段骨干区）为皮质松质骨交界；Ⅵ区（踝上区）位于踝关节周围，皮质薄，松质骨。临床上胫骨远端常指Ⅴ、Ⅵ区。胫骨远端骨折包括两大部分，即不经过踝关节的骨折和经踝关节的Pilon骨折。因胫骨远端涉及踝关节及骨质本身的解剖学特点，一盲是临床研究的热点。     

胫后血管肌间隙支胫骨内侧骨膜瓣移位术的应用解剖

目的：为胫后血管肌间隙支胫骨内侧骨膜瓣修复胫骨中、下段骨折、骨不连提供解剖学基础。方法：４０侧经动脉内灌注红色乳胶的成人下肢标本，观测胫骨内侧面骨膜血管来源、走行、分支分布及其吻合。结果：胫后动脉发肌间隙支２～７支，平均每侧２．２支，外径１．１±０．２ｍｍ。肌间隙主分出升支、降支，分布胫骨内侧中、下段骨膜，形成骨膜动脉网。结论：以胫后血管肌间隙支为蒂设计胫骨内侧骨膜瓣，可修复胚骨中、下段骨不连，已应用于临床。     

胫后动脉筋膜皮支为蒂的小腿内侧皮瓣与超薄皮瓣应用解剖

解剖１０具新鲜成年尸体的下肢，并将小腿内侧全厚皮片作透明标本观察，采用超声Ｄｏｐｐｌｅ探测正常活体小腿２０例。结果显示：胫骨滋养动脉自胫后动脉后出后即分为两支：胫骨滋养支与筋膜皮支。筋膜皮支在穿深筋膜前长度为３．３（１．５～８．４）ｃｍ；在皮下组织内的长度为２．５（１．４～４．８）ｃｍ，外径１．２（０．８～２．０）ｍｍ；在真皮下的长度为１．０（０．２～２．１）ｃｍ，外径为１．０（０．５～１．１）ｍ     

带血供胫骨外侧骨膜瓣移位术的应用解剖

目的：寻找一种不牺牲小腿主于血管的带血供胫骨外侧骨膜瓣，修复胚骨中、下段骨不连接，方法：在４０侧经动脉灌注红色乳胶的成人下肢标本上，解剖观测胫骨外侧中、下段骨膜血管来源、分支、分布及其吻合。结果：胚骨中、下段外侧，主要有来自胚前、胫后动脉穿支呈节段分布的骨膜主和肌骨膜支４～８支。每支间距４．６±１．６ｃｍ，蒂长０．９±０．５ｃｍ，动脉外径０．６±０．３ｍｍ，有２条伴行静脉。血管到达骨面多呈向上或水平走行。在胫骨外侧，骨膜支之间有分支形成吻合网。在胫骨前缘处分出升支、降支和皮支，并形成吻合链。结论：以节段血供的胫骨骨膜支为蒂作成胫骨外侧骨膜瓣，可用于治疗胫骨中、下段骨不连接。     

股骨滋养动脉髓内行径与髓内针固定的关系

目的：为了减少应用髓内针对股骨髓内血供造成的损伤。方法：观察了３０根尸体股骨的髓内血管行径，另和２根股骨进行扩髓与不扩髓内针固定，比较其对髓内血管的损伤程度 。结果：（１）６０％股骨有上、下２条滋养动脉，４０％仅有１条上洋养动脉，其中上滚养动脉为主要动脉。上、下滋养动脉的髓腔进入点，分别位于股骨中、上１／３交界处及中点附近。（２）滚养动脉进入骨髓腔分成升、降两支髓内动脉，其主干均位于腔后方并紧巾髓     

下颌骨血供系统的研究及其临床意义

目的：研究下颌骨的血供，为有关下颌骨的外科临床提供解剖学基础。方法：将6例墨汁灌注的新鲜下颌骨标本制作成透明标本，对其血供系统的分布、走行及吻合情况进行观测分析。结果：下牙槽动脉自上颌动脉发出后，由下颌孔进入下颌骨，走行于下颌管内，营养下颌骨体部和下颌孔以下的升支部分。每侧下牙槽动脉共发出6条分支来营养牙齿和牙周组织。下颌骨表面骨膜内有大量的血管网，以嚼肌及翼内肌附丽部分最为丰富。下颌孔以上升支部分，包括髁突和冠突则完全由来自于骨膜的血管网营养。结论：下颌骨血供主要由下牙槽动脉以及骨膜动脉网分布，两者之间存在丰富的吻合，为下颌骨炎症扩散以及口腔癌的下颌骨骨转移提供了血管途径；骨膜动脉网的存在亦是正颌外科中下颌骨游离骨段的营养保证。     

以内踝前血管为蒂胫骨远端内侧骨膜瓣移位术的应用解剖

目的：为内踝前血管胫骨远端内侧骨膜瓣移位术提供解剖学依据。方法：30侧经动脉灌注红乳胶成年下肢标本，观测内踝前动脉的来源、走行、分支分布、邻近吻合及胫骨远端内侧面的骨膜血管结果：内踝前动脉起于胫前动脉或足背动脉，紧邻胫骨前肌腱内侧行向前内，在楔骨内缘与足底内侧动脉浅支．或跗内侧动脉后行支形成吻合。动脉滞途发出3～6支外径为03～1．0mm的内踝骨膜支，分布内踝区骨膜，并与其它来源的胫骨远端内侧而骨膜动脉相吻合。结论：以内踝前血管为蒂的胫骨远端内侧骨膜瓣，顺行移位可修复胫骨远端骨不连，顺行或逆行移位可用于修复距骨颈骨折和距骨体缺血性坏死。     

The microcirculation of bone and marrow in the diaphysis of the rat hemopoietic long bones.

The nature of the microcirculation of the diaphyseal portion of long bones and the adjacent bone marrow is poorly understood. The purpose of this study was to describe the blood supply in the diaphyseal cortex and the relationship of the bone vascular circulation to that of the bone marrow in the growing rat. India ink-gelatin was infused in the arterial system of 3-month-old rats and the vascularization was determined from histological sections. In some studies the periosteal circulation was blocked but the nutrient and metaphyseal arteriole systems were left intact. In the growing rat, most of the vascular flow appears to be centripetally through the diaphyseal cortex and this appears to be the primary blood supply for the adjacent bone marrow. The India ink traversed the cortex and entered the marrow through osteal canals at the endocortical surface. At the marrow-endocortical bone surface interface, ink exiting from the osteal canals filled the adjacent marrow sinusoids in what appeared as "bush-like" structures. From the bone marrow the ink appeared to drain into the central vein. Some arterioles from the nutrient system were found to penetrate the inner two thirds of the cortical bone and then re-enter the bone marrow. The centripetal flow of blood and the importance of the cortical flow for perfusion of the hemopoietic tissue was further documented when periosteal flow was obstructed. In this situation, the cortical bone and adjacent bone marrow were not perfused while the nutrient system and central vein were filled with ink.(ABSTRACT TRUNCATED AT 250 WORDS)     

婴幼儿胫骨骨髓的血液供应

本文报道用血管注射、显微摄影及扫描电镜等方法,研究了42侧婴幼儿胫骨的骨髓血液供应。滋养动脉是骨髓的主要血供来源。干骺端动脉增强干骺部的血液供应。骨髓静脉比动脉更为丰富。骨髓静脉血主要经由髓静脉窦、集合静脉窦、中央静脉和滋养静脉回流。干骺端的部分血液经干骺端静脉回流。     

The microcirculation of the bone marrow

The microcirculation in the bone marrow has been studied in the femur, tibia, and humerus of guinea pigs, rats, and rabbits. Used were whole mounts of bone with bone marrow in situ, perfused and not perfused with India ink, thick sections (0.5 to 1.0 mm) of the same material, and also serially cut histological sections. It is concluded that the major blood supply to the bone marrow is transosteal. Direct intramyeloid connections of the arborizations of the nutrient artery with the sinusoids are rare. The great majority of the terminal capillaries of the nutrient artery enter the bone, where they anastomose with the intraosteal vessels which in turn connect with the sinusoidal network at the osteomyeloid junction. In addition, numerous direct links exist between the periosteal vessels and the vessels in the osteal canals.     

Effects of periosteum wrapped around tendon in a bone tunnel: A biomechanical and histological study in rabbits

The present study demonstrated the effects of periosteal autograft on tendon-to-bone healing in the rabbits. In 20 Japanese white rabbits, proximal end of the long digital extensor tendon that was wrapped around by a periosteum was transplanted into a drill hole in the proximal tibial metaphysis. A fresh periosteum was used in the left tibia and a frozen periosteum was used in the right tibia. Six specimens were harvested at each 2, 4, and 6 weeks postoperatively. Radiological features showed progressive remodeling of trabecular bone surrounding the implanted tendon. This remodeling in fresh periosteal graft was earlier than that in frozen graft. Generally, the pull-out strength of the transplanted tendons with a fresh or frozen periosteum increased progressively according to the length of the healing periods. The strength was significantly greater in a fresh periosteal graft than that in a frozen graft at 4 weeks postoperatively. In histological analysis, a 4-week specimen with the fresh periosteal graft showed fibrocartilage formation in the bone tendon interface, whereas the specimens with the frozen graft demonstrated simple approximation of oriented fibrous tissue. In conclusion, the fresh periosteal autograft produced the premature form of fibrocartilagenous attachment in a bone tunnel and provided good mechanical strength.