带血管蒂小腿内侧筋膜皮瓣设计改进的解剖学基础

目的 :为临床小腿内侧筋膜皮瓣设计改进提供解剖学依据。方法 :应用 32例下肢标本 ,通过动乳胶灌注、墨汁灌注及铸型腐蚀等方法 ,对小腿内侧带血管蒂的筋膜皮瓣进行顺行和逆行转位的可行性探讨。结果 :在小腿内侧区浅、深筋膜层内有一组出现较高 ,口径较粗大的桥式纵行血管链 ;隐动脉血运可通过此血管链到达小腿下段 ;同时该血管链与膝降动脉的隐支以及胫后动脉的筋膜皮支有广泛的吻合。结论 :带隐动脉的筋膜皮瓣往下可延长至小腿下段 ,而小腿内侧逆行筋膜皮瓣往上可延长取至髌骨下缘。

ANATOMIC BASIS OF THE IMPROVMENT BASED ON MEDICAL CRURAL FASCIOCUTANEOUS FLAP WITH BLOOD PEDICLE

Objective:To provide anatomic evidence for clinical development of medial crural fasciocutaneous flap. Method:Based on anatomical studies of 32 lower limb specimens of infant cadavers by means of red Latex and black ink injections and cast specimen corrosion.Results:There is a group of longitudinal bridge-shaped blood vessel links with high presence rate and big diameter,existing both on the superficies and deep layer of medial crural fascia,and the blood supply of saphencus artery can reach inferior crural region surface through the blood vessel links.Conclusions:The fasciocutaneous flap with saphenous artery can be extended to the inferior part of the leg,while the medial crural reverse fasciocutaneous flap could reach superiorly the inferior margin of the potella.