股深血管及穿血管股骨膜(骨)瓣转位的应用解剖

APPLIED ANATOMY OF TRANSPOSITION OF FEMORAL OSTEOPERIOSTEAL FLAP PEDICLED WITH PERFORATING ARTERY OF DEEP FEMORAL VESSELS

目的：为股骨骨折、骨不连提供带血管蒂骨膜（骨）瓣转位修复的解剖学基础。方法：在４０侧成人下肢标本上，解剖观察了股深血管穿支的起始、走行、分支、吻合及骨膜支。结果：股深血管主干经大收肌和短收肌之间，贴股骨后内侧下降直达大收肌止端深面，沿途分出３～４支穿动脉，起始点距小转子尖下依次为４．５±１．３ｃｍ、９．３±２．６ｃｍ、１４．３±３．１ｃｍ和１６．０±１．５ｃｍ，外径分别为２．８±０．７ｍｍ、２．４±０．６ｍｍ、２．２±０．５ｍｍ和１．３±０．２ｍｍ。各穿支分出１～３支外径１．０ｍｍ左右的肌骨膜支，分布股骨体粗线及粗线两侧骨膜，形成骨膜动脉网。结论：以股深血管及其穿支为蒂可设计３种骨膜（骨）瓣修复股骨各段骨折骨不连。

Objective:it is order to provide anatomical basis for transposition repairing femoral fracture,nonunions by the femoral osteoperiosteal flap pedicled with vessele.Methods:The origin,course,branches,anastemosis and periosteal branch of the perforating branch of deep femoral vessels were observed on 40 sides of adult cadaveric lower limbs.Results:The deep femoral vessels descend to arrive at the profundity of termination of great adductor muscle by the posterior medial of femur between the great adductor muscle and the short adductor muscle.The deep femoral artery send to 3～4 perforating branch,the perforating branch is 2 8±0 7 mm,2 4±0 6 mm,2 2±0 5 mm,and 1 3±0 2 mm,from origin to down lesser trochanter is 4 5±1 3 cm,9 3±2 6 cm,14 6±3 1 cm and 16 0±1 5 cm.The perforating branch send to 1～3 muscle-periosteal branch up 1 0 mm,cover linea aspera of femoral shaft and periosteal of two lateral linea aspera,constituted periosteal artery network.Conclusion:It is 3 periosteal(bone) flap with the deep femoral vessels and the perforating branch to provid a new donor site for repairing fracture or nonunion at the any part of femur.