带血管蒂股骨外侧髁骨膜(骨)瓣移位术的应用解剖

目的　为修复股骨中、下段提供一新的骨膜（ 骨）供区。方法　在４０ 侧成人下肢标本上，解剖观测股骨外侧髁和股骨下段前面的血管来源、走行、分支和吻合情况。结果　膝外上动脉起自月国动脉，经外侧髁上方穿股二头肌腱与股外侧肌间隔至骨面发骨膜支分布于外侧髁的外侧面并参与股骨前面骨膜血管网。股动脉直接骨膜支约在股骨中下１／３ 交界处，发自股动脉，斜向外下行分布于股骨下段前面。结论　以膝外上动脉为蒂的股骨外髁骨膜（ 骨） 瓣移位可修复股骨髁上部；以股动脉直接骨膜支为蒂可修复股骨中段。

Applied anatomy for transposition of pedicled external femoral condyle osteoperiosteal flap

Objective To provide a new supplied site of osteoperiosteal flap for repairing the middle and distal femur. Methods The origin, course, branches and anastomosis of vessels at the external femoral condyle and anterior side of the distal femur were observed on 40 adult cadaver lower limb specimens. Results The superiolateral genicular artery stemmed from the popliteal artery, penetrated biceps femoral muscle and lateral intermuscular septum of the femur to the surface of femur by the superior side of the external condyle sending periosteal branches to the external condyle and participating in the anterior periosteal vessels network of femur. The direct periosteal branch of femoral artery stemmed from the femoral artery about 1/3 connection of the middle and distal femur, slanted toward inferiolateral distributing to anterior side of the distal femur. Conclusion The transposition of external femoral condyle periosteal flap pedicled with superiolateral genicular artery or the direct periosteal branch of femoral artery could be designed to repair the superior part of femoral condyle or the middle segment of femur respectively.