跗外侧动脉分支为蒂的足外侧皮瓣解剖及临床应用

Anatomic study and clinic application of lateral pedal retrograde flap with lateral tarsal artery

目的：为临床上足部软组织缺损的修复提供一种新的术式。方法：４０侧动脉内灌注红色乳胶的成人足标本，解剖观测跗外侧动脉的走行、分支、分布及其远端吻合情况。在解剖学研究基础上，设计跗外侧动脉足外侧逆行皮瓣移位术。结果：①跗外侧动脉由足背动脉发出，其体表投影线相当于踝间连线下２．６±１．１ｃｍ足背动脉搏动点至第５跖骨底连线。动脉起始处有一外径０．５±０．２ｍｍ、长１．０±０．２ｍｍ的皮支较恒定，终支形成前行支和后行支，分别向前、后行与弓状动脉、跟外侧动脉相吻合；②经临床应用６例，皮瓣全部成活。创面Ⅰ期愈合５例，经短期换药愈合１例。结论：以跗外侧血管终支之一（前行支或后行支）为蒂可形成足外侧逆行皮瓣，转位修复足跟、外踝及足背远侧皮肤缺损。

bjective:To provide a new operative method for repairing soft tissue defect of dorsum pedis.Methods:The origin、course、branches、distribution and anastomosis of the lateral tarsal vessels were observed on 40 sides of adult cadaveric lower limbs perfused with red latex in artery.Based on the anatomic study,transposition of lateral pedal retrograde flap with lateral tarsal artery was devised.Results:①The lateral tarsal artery originates from the dorsal pedal artery 2.6±1.1 cm below the connecting line of medial and lateral malleoli and extends to the base of the fifth metatarsal bone.One skin branch of the artery is constant with an external diameter of 0.5±0.2 mm at the original site and 1.0±0.2 cm in length.This skin branch sends off forward and backward branches to anastomose with the arcuate artery anterioly and the calcaneus artery posteriorly;②Operation with the newly devised flap were carried out successfully in 6 cases.Conclusions:The retrograde flap can be used in repairing skin defects in the heel,lateral malleolus and distant dorsum pedis regions.