小腿内侧逆行筋膜皮瓣修复足部创面的解剖研究及临床

Reverse transposition of the medial crural fasciocutaneous flap-Anatomic study and clinical application

在４４侧下肢标本上，通过动脉乳胶灌注、墨汁灌注及铸型腐蚀等方法，对小腿内侧筋膜逆行转位的可行性进行了探讨，该筋膜皮瓣的血供主要以胚后动脉下１／３段发出的肌间隙皮动脉供应，平均每侧有２．１（１～３）支，外径０．７ｍｍ；该筋膜皮支在胫骨内侧缘附近的浅、深筋膜内与胚后动脉在小腿中、上部发出的数条筋膜皮动脉及膝降动脉的隐支间有广泛的吻合，形成血管链，故以胫后动脉下１／３段的皮动脉为蒂，筋膜皮瓣可截取范围，上界可达髌骨上缘，下界可达内踝上１ｃｍ，前界至前正中线，后界达后正中线，面积达３５×１５ｃｍ，用以修复足部软组织缺损，经７例临床应用，效果满意。

ased on anatomical studies of 44 lower limb specimens of adult human cadavers by means ofred latex and black ink injections and cast specimen corrosion,the authors evaluated the possibili-ty of reverse transposition of the medial crural fasciocutancous flap.The arterial supply to the me-dial side of the leg was observed mainly from the distal one-third of the posterior tibial artery,av-eragely 2(1 to 3)in number and 0. 7mm in external diameter which passes through th,intermus-cular space, A fasciocutaneous flap in the region could be designed with a maximal area of 35×15cm,which reaches superiorly the superior margin of the patella,inferiorly lcm above the levelof medial malleolus, and laterally the anterior and posterior median lines of the leg. Reverse trans-position of the fasciocutoneou;flap has been clinically applied to the treatment of foot soft tissue defects in 7 cases with satisfactory results,