缝匠肌深层肌间筋膜蒂髂骨瓣的解剖学基础

Anatomic Basis on Transposition of Iliac Bone Flaps Pedicled with Sartorius Muscular Fascia

目的 探讨带缝匠肌深层肌间隙筋膜蒂的髂前上下棘间骨瓣转位治疗股骨颈部位病变的解剖学基础。方法 在30侧经动脉灌注红色乳胶的下肢标本上，对缝匠肌深层的肌间筋膜的血管分布和走行进行观察。1例进行摹拟手术。结果 该肌间隙行走的血管主要由来自旋股外侧动脉的升支及其分支一阔筋膜张肌支、髂嵴支、臀中肌支、髂前下棘支和来自旋髂浅动脉与旋股外侧动脉的缝匠肌节段性血管，上述血管相互吻合形成丰富的肌间筋膜血管网。采用缝匠肌深面肌间筋膜蒂的髂前上下棘间骨瓣移植，髂嵴支和缝匠肌的节段性血管可保留，肌筋膜蒂的长度可以达到6—8cm。结论 以缝匠肌深层肌间筋膜蒂的髂前上下棘间骨瓣转位移植可用于修复股骨颈部组织缺损。

Objective To discuss anatomic basis for transposition of iliac bone flaps between anterior superior iliac spine and anterior inferior iliac spine pedicled with sartorius muscular fascia and intermuscular septum vessels. Methods On 30 adult cadavers perfused with red emulsion, the sartorius muscular fascia and intermuscular septum vessels among the sartorius muscle, the femoris rectus muscle and the tensor muscle of fasci lata were observed, and the operations were imitated on 1 adult cadveric limb. Results The sartorius muscular fascia and intermuscular septum needed in clinical operation were limited to the point about lOcm descended form the spina iliaca anterior, The vessels of the sartorius muscular fascia and the iliac crest branches of ascending ramus of lateral femoral circumflex vessels were the supplied vessels. The pedicle length of the sartorius muscutar fascia and intermuscular septum was 6 - 8cm. Conclusion The method can be used as a base vessel of the neck of femur.