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。

Applied anatomy of the transposition of the periosteal flap pedicled with the medial anterior malleolus vessel on the distal base of the medial tibia

Objective: To provide anatomic basis for transposition of the periosteal flap pedicled with the medial anterior malleolus vessel on the distal base of the medial tibia. Methods: The origin, course, branches distribution, and anastomosis of medial anterior malleolus artery and periosteal vessels on the distal base of the medial tibia were observed on 30 adult cadaveric foot specimens. Results: Medial anterior malleolus artery along medial sides of tendon sheath of anterior tibial muscle was anastomosed with the superficial branch of medial plantar artery or the medial taesal artery in the medial cuneiform bone. The arteries sent out 3~6 pieces periosteum branches with diameter 0.3-1.0mm, which distributed to the periosteal of medial malleolus and was anastomosed with the periosteal artery on the distal base of the medial tibia. Conclusions: It is feasible to repair fracture of medial malleolus, neck of talus fracture and ischemic necrosis of talus body by achieving the transposition of periosteal flap pedicled with the medial anterior malleolus vessel on the medial of tibia distally based.