腓深神经和足背动脉在足背位置关系的应用解剖

目的探讨腓深神经和足背动脉的位置关系，为外科皮瓣手术和足部手术提供解剖学资料。方法通过解剖36例尸体下肢，观察在踝前区及足背腓深神经与足背动脉的位置关系。结果腓深神经和足背动脉有四种类型的位置关系。第一种（36．1％），在踝前区内，足背动脉在腓深神经内侧走行；在足背，足背动脉走行在腓深神经内侧终末支的内侧。第二种（25％）在踝前区内，足背动脉走行在腓深神经的内侧；在足背，足背动脉走行在腓深神经内侧终末支的的外侧。第三种（30．6％），足背动脉和腓深神经在多处出现交叉走行。第四种（8．3％）腓深神经内侧终末分支缺失，足背动脉在腓深神经外侧终末支的内侧走行。结论四种类型出现机率不同，位置关系有所差异，在足外科手术和皮瓣制作时要充分了解此处神经和血管的位置变化。

The clinical importance of the relationship between the deep peroneal nerve and the dorsalis pedis artery on the dorsum of the foot

Objective To describe the relationship between the deep peroneal nerve and the dorsalis pedis artery to help ensure a safer surgical approach in flap surgery. Methods The dissection of 36 cadaver lower limbs was undertaken to describe the relationship of the deep peroneal nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. Results 4 distinct relationships of the deep peroneal nerve to the dorsalis pedis artery were determined. In type 1 （36. 1 percent）, the artery was medial to the deep peroneal nerve in the tunnel and medial to the medial terminal branch below the tunnel on the dorsum of the foot. In type 2 （25.0%）, the artery was medial to the deep peroneal nerve in the tunnel andolateral to the medial terminal branch below the tunnel on the dorsum of the foot. In type 3 （30. 6% ）, the deep peroneal nerve and the artery were crossing over each other at multiple levels. In type 4 （ 8.3 percent）, no medial terminal branch was observed. The artery was medial to the lateral terminal branch. Conclusions The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep peroneal nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here will help surgeons during the surgical approaches to the foot and ankle.