旋股外侧血管蒂复(联)合组织瓣移植的解剖学基础

The anatomic basis on transplantation of tissue flap pedicaled with lateral femoral circumflex artery

目的:为以旋股外侧血管蒂复(联)合组织瓣移植提供解剖学基础。方法:50侧成人下肢标本解剖观察旋股外侧动脉分支起始类型及其分布。结果:旋股外侧动脉分支起始主要有3型:Ⅰ型:旋股外侧动脉发升支、横支和降支占76％;Ⅱ型:升支、横支、降支由两干从股深动脉或股动脉发出占20％;Ⅲ型:升支、横支、降支单独从股深动脉或股动脉发出占4％。升支恒定分支分布于阔筋膜张肌和髂嵴前外侧部;横支分支分布于股外侧肌上部和大转子前外侧部;降支分支分布于股外侧肌和股前外侧部皮肤。结论:76％可以旋股外侧血管为蒂形成:①升支阔筋膜张肌皮瓣和/或髂骨瓣;②横支大转子骨瓣或骨膜瓣;③降支股前外侧皮瓣。20％则可以升支和横支或横支和降支共干形成相应两个组织瓣。

Objective: To provide anatomic basis for transplantation of tissue flap pedicaled with lateral femoral circumflex artery. Methods: 50 adult lower limb specimens were dissected. The type of branches and distribution of lateral femoral circumflex artery were observed. Results: There were 3 types of branches for lateral femoral circumflex artery: The ascendmg, transverse and descending branches carne from lateral femoral circumflex artery directely belonged to l Ⅰ types, which occupied about 76%. In type Ⅱ , the ascending , transverse and descending branches were sent from profunda femoris artery patterned with two shafts or from femoral artery, the pencentage was about 20%. The ascending ,transverse and descending branches originated from profunda femoris artery solely belonged to Ⅲ type, which occupied about 4%. The ascending branches supplied tensor fasciae latae and anterolateral part of iliac crest continuously. The transverse branches reached the superior part of vastus lateralis and anterolateral part of greater trochanter, while the descending branches distributed to vastus lateralis and the skin of anterolateral region of thigh. Conclusions: In most specimens, lateral femoral circumflex artery can be taken as supplied vessel to form tissue flaps as follow:① Tensor fasciae latae myocutaneous flap and iliac bone flap pedicaled with ascending branches. ② Bone flap or periosteum flap of greater trochanter pedicaled with transverse branches. ③ Skin flap of anterolateral region of thigh. In addition, ascending and transverse branches or descending branches can form two corresponding tissue flaps by the pattern of converging into one shaft in 20% specimens.