腓骨短肌肌瓣的血供研究与临床应用

The blood supply of the peroneus brevis muscle flap and its clinical application

目的了解腓骨短肌血供的解剖学特征,探讨临床应用腓骨短肌肌瓣和以腓骨短肌为蒂的组织瓣内移修复踝周软组织缺损或治疗胫骨骨不连的可行性。方法 30例经10%福尔马林固定的成人下肢标本,动脉灌注红色乳胶,解剖观察腓骨短肌的血管来源、走行及分布情况;临床上设计切口取腓动脉的弓形动脉分支为蒂,修复踝周软组织缺损和胫骨骨不连患者10例。结果腓骨短肌血管呈节段性分布,主要来自腓动脉的弓形动脉,最远侧的分支平均位于外踝上(50.81±5.45)mm;根据腓骨短肌及血供特点,临床设计的腓骨短肌肌瓣应用于10例患者,均获成功。结论腓骨短肌血供丰富,逆行腓骨短肌肌瓣血供可靠,是修复踝周软组织缺损和胫骨骨不连的一种理想肌瓣。

Objective To understand anatomic features ofthe blood supply of peroneus brevis muscle,and explore the viability of the peroneus brevis muscle flap or pedicled peroneus brevis muscle flap transfer within soft tissue for repairing ankle soft tissue defeats or the tibial nonunion.Methods Thirty fixed adult lower limb specimens were perfused with red emulsion.The vessel origin,course and distribution of the peroneus brevis muscle were dissected and observed.For 10 cases,arcuate arteries of peroneal artery were taken as a pedicle to repair soft tissue defects in ankle and tibia bone nonunion.Results The vessels of peroneus brevis showed a segmental distribution,mainly from the arcuate arteries of peroneal artery,and the average distance of the most distal branch to lateral malleolus was about（50.81 ±5.45）mm.According to anatomic features of peroneus brevis muscles and its blood supply,peroneus brevis muscle flap was designed and used to treat 10 patients successfully.Conclusions The blood supply of peroneus brevis muscle was rich and stable,which can be taken as the ideal muscle flap to repair ankle soft tissue defects and tibial nonunion.