带肋间神经外侧后支背阔肌感觉皮瓣的应用解剖

目的：为形成带感觉神经的背阔肌游离皮瓣提供解剖学基础，方法：在20具40侧成人躯干标本上，采用大体解剖方法结合4倍显微镜，解剖后背区及侧胸区层次结构，观测分布于背阔肌区域的间神经的来源，走行及分布规律。结果 T5－10神经外侧支的后支在腋前线1－2cm相应间穿出，水平向后背走行较长距离，在肩胛下角线附近浅出皮下，呈节段性，重叠性分布肩胛线以外的背阔肌区皮肤，并与下位胸脊神经后支在肩 胛下 线相吻合，其中T6－8外侧支的后支分支分布于皮瓣范围较大，神经蒂较长并与血管蒂较近，结论：可设计以第6－8肋间神经外侧后支为神经蒂的背阔肌感觉皮瓣。

APPLIED ANATOMY OF THE SENSATE LATISSIMUS DORSAL MUSCULAR FLAP WITH THE LATERAL POSTERIOR BRANCH OF THE INTERCOSTAL NERVE

Objective To provide anatomy basis for a free latissimus dorsal muscular flap with the sensate nerve. Methods The structure of back and lateral chest area were dissected and the origin, alignment and distribution of the intercostals nerve within the area of latissimus dorsal muscular flap were observed in 40 adult cadaver specimens. Results The 5th to 10th lateral posterior branches of the thoracic nerve pierced from respective intercostal area near the axial anterior line and run a long distance in deep fascia. They distributed mainly in lateral latissimus skin outside the scapular line and anastomosed with the lower branch near the scapular line. Among these branchs, the 6th to 8th branches had a longer nerve distribution respectively and the pedicle of nerve and artery was parallel and long. Conclusion It is possible to design a sensate latissimus dorsal muscular flap with the 6th to 8th lateral posterior branch of the intercostal nerve.