踝足部血管吻合支的研究与吻合胫前或胫后动脉逆行皮瓣的设计

目的：研究胫前动脉、胫后动脉和腓动脉之间在足踝部的吻合支的粗细，为吻合胫前或胫后动脉远端逆行血供皮瓣设计提供解剖学基础。方法：46侧新鲜小腿的动脉灌注红色塑料，制成动脉铸型标本。观察胫前、胫后和腓动脉在踝足部的吻合支的形态，测量血管的内径。结果：胫前、胫后和腓动脉三者之间在足踝部的吻合支丰富，胫后动脉经足底弓、足底深支与胫前动脉的吻合支最粗，内径为2.3mm。结论：胫前、胫后和腓动脉三者之间在足踝部的吻合支丰富，胫前动脉或胫后动脉之一断裂或栓塞时，只要三者之间在踝足部的主要吻合支未遭受破坏，胫前动脉或胫后动脉远端仍可作为皮瓣受区血管被利用。

The study of arterial anastomotic branches in ankle and foot and the design of flap anastomosed reversedly with the anterior or posterior tibial artery

Objective:To investigate the calibers of anastomotic branches among the anterior tibial artery,the posterior tibial artery and the peroneal artery in ankle and foot,in order to make clear the anatomic basis of flap which was anastomosed to the distal stump of the anterior tibial vessels or the posterior tibial vessels with reversed flow.Methods:46 legs of fresh adult cadavers were involved.Red plastic was perfused into the anterior tibial artery to make cast specimen.The configuration and inner caliber of anastomosis branches among the anterior tibial artery,the posterior tibial artery and the peroneal artery in ankle and foot were observed.Results:There are many anastomosis branches among the anterior tibial artery,the posterior tibial artery and the peroneal artery in ankle and foot.Anastomotic branch passing through the plantar arterial arch and ramus plantaris profundus between the anterior tibial artery and the posterior tibial artery was the widest,its inner caliber was 2.3 mm.Conclusion: As long as communication among the anterior tibial artery,the posterior tibial artery and the peroneal artery in ankle and foot was not destroyed,when the anterior tibial vessels or the posterior tibial vessels was embolized or broken due to posttraumatic lesion,distal stump of the anterior tibial artery or the posterior tibial artery can be used in recipient site of flap also.