足背皮瓣与足外侧或外踝上哑铃状联合皮瓣设计的解剖基础

目的:为手部复杂外伤并两处皮肤缺损及深部组织损伤外露的修复提供理想的皮瓣供区.方法:40侧动脉灌注红色乳胶的成人下肢标本,解剖观测胫前血管、腓血管穿支降支在踝前的分支、分布、外径及其远端吻合情况.结果:胫前动脉在踝间或踝上向外侧恒定地发出外踝前动脉.根据胫前动脉外踝前支的分出位置、粗细及与腓动脉穿支降支的吻合情况,可将其分成以下四型.两主干血管吻合后下行经外踝前至足背外侧与跗外侧动脉吻合,沿途发出皮支营养胫前踝上和足背外侧.结论:可以在形成以胫前血管为蒂的足背皮瓣同时,以胫前血管的外踝前动脉为血供设计足外侧或外踝上联合皮瓣应用.

Applied anatomy of the dorsum flap and lateral dorsum flap or superior lateral malleolus combined flap

Objective: To provide best tissue donor site for the repair in hand serious injury with two area skin defect and deep tissue injury and exposure. Methods: Branches, distribution, external diameters and anastomosis were observed on 40 adult lower limb specimens. Results: lateral malleolus branches were formed from anterior tibial artery on or between the ankles. Four types were put up according to the position, external diameters of lateral malleolus branches of anterior tibial artery and its anastomosis with terminal branch of peroneal artery. These vessels distributed on ankle and dorsi lateral foot. Conclusions: Dorsum flap can be combined with lateral dorsum flap or superior lateral malleolus combined flap at the reparative surgery.