带血管蒂舟骨瓣移位术的应用解剖

Applied anatomy for transposition of navicular bone flap with vessel pedicle

目的:为治疗距骨骨折提供新术式的解剖学基础.方法:在30侧灌注红色乳胶的成人下肢标本上,对舟骨背侧面形态、血供来源进行观测.结果:舟骨背侧面动脉主要来自内踝前动脉、跗内侧动脉以及足底内侧动脉浅支,分别发3～5支、1～3支和1～2支外径在0.2～1.0mm之间的骨膜支,形成骨膜动脉网.结论:以内踝前血管为蒂,可切取舟骨背侧2.0cm×1.0cm×0.5cm大小的骨瓣,用于距骨颈骨折修复.术式经临床应用证实,手术简便,效果可靠.

The morphosis, blood supply of dorsal area of navicular bone were observed on 30 sides of adult cadaveric lower limbs with red latex in artery in order to provide anatomical basis for the new treatment of talus fracture. It was found that the arteries of dorsal area of navicular bone originated from medial anterior malleolar artery, medial tarsal arteries and superficial branch of medial plantar artery. These arteries send off 3 - 5, 1- 3, 1- 2 periosteal branches with external diameter of 0. 2-1. 0 mm and constitute periosteal artery network. It was suggested that 2. 0cm X 1.0cm X 0. 5cm flap of dorsal area of navicular bone with medial anterior malleolar artery could be used for repairing neck fracture of talus. Satisfactary results were achieved in clinical practice.