趾长伸肌瓣的解剖学研究

Anatomical study of extensor digitorum longus muscle flap

在３０侧成人下肢标本上观察了趾长伸肌的形态、血供和神经支配。测得肌长２９．８ｃｍ；该肌除由８～２０支胫前动脉横向分支供应外，肌下份还有１～３支腓动脉穿支供应，前者动脉主要从肌的内侧入肌，后者主要从肌的后方入肌；腓深神经约发出３支分布该肌，从肌的内侧或后方入肌。利用趾长伸肌可制作以远端为蒂的翻转肌瓣，其肌蒂最低点在外踝突出点上方７．０ｃｍ，该肌瓣对小腿中下部开放性胫骨骨折及慢性骨髓炎等，似为较理想的供肌。此外，还对手术方式进行了探讨。

The shape,blood supply and nerve distribution of the extensor digitorum longus muscle were observed on 30 sides of lower limbs of adult cadavers. The length of the muscle belly is 29. 8cm.The muscle is supplied by 8￣20 transverse branches of anterior tibial arteryi in addition, lower part of the muscle is supplied by l￣3 perforating branches of peroneal artery. The former arteries enter the muscle mainly on the medial surface and the latter on the posterior suface. Three branches of the deep peroneal nerve innervating the muscle enter the muscle on the medial or posterior surface. This muscle can be used as a turn-down muscle flap with retained distal muscular pedicle, and the lowest point of the pedicle is about 7cm above the lateral malleolus. Therefore,the muscle is a suitable donor inuscle for treating open tibial fracture and chronic osteomyelitis of the middle and lower parts of leg.