组织瓣移植修复小腿毁损时供区血管蒂的应用研究

目的：取旋股外侧动脉降支血管逆行转位供血,与组织瓣移植吻合一次性修复小腿毁损伤.方法：取30例动脉内灌注红色乳胶的成人下肢标本（男女各15例）,以髂前上嵴、髌骨上缘为标志解剖观测（D旋股外侧动脉降支血管的走行、分支、分布与起始处外径;②血管外径在0.Smm和0.5mm时分别与起始处、髌骨下缘的距离;③旋眨动脉降支与膝周围动脉的吻合关系.结果：降支血管起始处的外径为（2.73±0.35）mm,外径为0.8mm时与起始处、髌骨下缘的距离分别为（21.55±1.23）cm、（9.09±1.09）cm;外径为0.5mm时与起始处、髌骨下缘的距离分别为（24.56±0.92）cm、（6.09±0.86）cm;旋股外侧动脉降支在下行过程中发出多支肌支、肌皮支和皮支,终支与膝上外侧动脉在骨膜处、深筋膜层和浅筋膜层均有广泛的吻合.结论：在小腿大面积毁损、创面无可供吻合的血管时,可取旋股外侧动脉降支血管逆行转位供血,与组织瓣移植吻合进行一次性修复.

The solution to recipient vessel pedicle of lower leg＇s destruction injury with flap transplant

Objective：On the basis of anatomical researches in the Descending branch of Lateral Femoral Circumflex Artery（LFCA）,to figure out the solution to recipient vessel pedicle of lower leg＇s destruction injury with flap transplant.Methods：30 embalmed lower limb specimens from adult cadavers perfused with red latex were used for this anatomical study.The superior of patella and anterior inferior iliac spine were used as observation points,for the following exploration：①The course,distribution and branches of the Descending branch of LFCA（DLFCA）;②The external diameter at the beginning of the DLFCA; the 0.8mm and 0.5mm external diameter point of this artery,and their length to the beginning and superior of patella;③Anastomoses relations between DLFCA and arteries around the knee.Results：The external diameter of the beginning of DLFCA is（2.73 ± 0.35） mm; the 0.8mm external diameter point of this artery＇s length to the beginning and to the superior of patella were（21.55 ± 1.23） cm and（9.09 ± 1.09） cm; the 0.5mm external diameter point of this artery＇s length to the beginning and to the superior of patella were（24.56 ± 0.92） cm and（6.09 ± 0.86） cm; there were many perforator arteries among the whole DLFCA; the final branch of DLFCA had lots of anastomoses relations in perioseal deep fascia and superficial fascia with the lateral superior genicular artery.Conclusion：When the lower leg happens to the huge destruction injury and there are no good vessels can used,we could take the DLFCA to regress and anastomosis with transplant flap to reconstruct the function of lower leg only one time.