带筋膜蒂跟骨瓣转位修复的应用解剖

在３０侧成人下肢标本上，观察了跟骨内侧和上腿内侧下１／３筋膜血管来源与分布情况，其中分布到跟骨内侧的滋养动脉主要来自足底外侧动脉与胫后动脉的分支，分别发出３～９支和２～５支外径０．６±０．４ｍｍ的骨支。小腿内侧下１／３筋膜的血供来自胫后动脉的肌间隙筋膜皮动脉，有１～３支，外径０．８±０．５ｍｍ。踝管区的骨皮支与肌间隙动脉的下行支相吻合。根据供区解剖学规律，充分利用筋膜血管明显纵向分布的特点，设计带筋膜蒂跟骨瓣，转位修复内踝骨折、骨不连。

Applied Anatomical on Transposition of Calcaneus Bone Flap with Fascia Pedicle for the Repair

The origin and distribution of blood vessels in the calcaneus medial and lower one third of the fascia of the leg were observed in 30 adult cadaveric feet. The branches of bone and skin of the medical plantar artery and the posterior tibial artery are the main nutrient arteries of the calcaneus medial. The arteries send 3～9 branches and 2～5 branches of the bone and skin, with diameters ranging from 0.6±0.4mm. The artery supplying the lower one third of the medial fascia of the leg were cutanous artery in intermuscular spaces which orginated from the posterior tibial artery. It is send 1～3 branches with diameters ranging from 0.8±0.5 mm. It is anastomotic that the branch of the bone and skin of the tarsal tunnel and the cutancous artery in intermuscular spaces. Based on the blood supplying of the marlced directonality of the fascia, it was designed for the treatment of medical malleolus fracture or nonunion by transposition of the calcancus bone flap with the fascla pedicle.