以节段性肌肉移植为目的的股薄肌应用解剖

Applied anatomy of gracilis muscle based on segmental muscle transplantation

目的对股薄肌的主次血管蒂进行显微解剖,为节段性移植提供参考。方法解剖40例福尔马林保存的股薄肌标本,采用一种比例测量法,解剖及测量动脉蒂以及神经和血管的伴行关系。通过将每1例标本营养血管的位置比例化,总结肌肉动脉及神经分布的规律。结果股薄肌有4条动脉供血,其中股深动脉/旋股内侧动脉肌支和股动脉肌支是恒定出现的两条营养动脉,管径粗大、长度充分,适于游离移植。它们分别在距肌肉近端1/5与距肌肉后缘2/3相交的位置、和距肌肉近端1/2与距肌肉后缘1/2相交的位置进入肌肉,95%的神经和血管伴行。结论股薄肌可以凭借主要营养动脉分支为蒂纵行游离移植,或分别以主次营养动脉为蒂横行游离移植。

Objective The microsurgical anatomy of gracilis muscle and its vascular pedicles were investigated to provide data for segmental muscle transplantation. Methods Forty formaldehyde solution preserved cadavers were dissected. The vascular pedicle and the relationship between nerves and blood vessels were observed and measured by a kind of ratio measure method. Results The gracilis was supplied by 4 arteries. The branches rising from deep femoral artery （or from medial femoral circumflex artery） and femoral artery were constant nutrition pedicles. These two branches have enough caliber and length to free muscle transplantation. The entry location of former pedicle was at the interception of 1/5 to proximal end and 2/3 to posterior border, and the entry location of the latter pedicle was at the interception of 1/2 to proximal end and 1/2 to posterior border. Conclusion The gracilis could be transplanted segmentally along the longitudinal axis by primary vascular pedicle, or transversely transplanted by primary and secondary pedicles respectively.