胫前动脉分支供养腓骨头的解剖学研究及其临床意义

Blood supply of the fibular head derived from the branches of anterior tibiai artery： anatomical research and its clinical significance

目的探讨胫前动脉分支作为供养腓骨头瓣血管蒂的可行性和安全性。方法在32侧成人尸体标本上观测供养腓骨头的胫前动脉分支的走行、分布、蒂长、管径及与腓总神经及其分支的毗邻关系。结果直接供养腓骨头的胫前动脉分支有胫前返动脉、直接腓骨头动脉、高位腓浅动脉。结论若选择腓骨头瓣的血管蒂，胫前返动脉蒂短、与自身伴行静脉及周边神经关系复杂，操作难度大、安全性差；直接腓骨头动脉血管蒂短，亦属勉强；高位腓浅动脉可以其远端为逆行蒂，可行性较大。

Objective To investigate feasibility and security of the branches of anterior tibial artery which were used as pedicles of the fibular head flap. Mehtods The course, distribution length of the pedicle, caliber of the branches of anterior tibial artery and their correlation with the peroneal nerve were observed and measured in 32 adult cadaveric lower limb specimens. Results Three branches, the anterior tibial recurrent artery, the direct fibular head artery and the high position superficial peroneal artery, derived from the anterior tibial artery and supplied the fibular head directly. Conclusion Of all the three branches of anterior tibial artery which are taken into consideration for used as pedicles of the fibular head flap, the anterior tibial recurrent artery has the disadvantages of short length of pedicle, sophisticated correlation with veins and nerves, so it is not a safe selection ; the direct fibular head artery is also unsuitable becuse of the short pedicle length; for the advantage of its retrograde pedicle can supply the fibular head reversely, the high position superficial peroneal artery is a reasonable selection.