腓血管蒂比目鱼肌皮瓣逆行转位修复术的应用解剖

Appied anatomy on the reverse transposition of soleus musculocutaneous flap pedicled with peroneal vessels

目的：为以腓血管为蒂比目鱼肌皮瓣逆行转位修复小腿中、下段组织缺损提供解剖学基础。方法：在３３侧经动脉灌注乳胶的下肢标本及６侧动脉铸型下肢标本上，解剖观测比目鱼肌形态，腓动脉比目鱼肌支的分布及腓动脉与胫前、后动脉之间的吻合。结果：腓动脉发出１～４条比目鱼肌支，外径２．０±０．５（１．０～３．８）ｍｍ，由其发出至皮肤的血管在比目鱼肌内或沿肌间隔穿行，穿出点在腓骨头下９．９±３．０ｃｍ，分布范围１６ｃｍ×９ｃｍ。腓动脉下端与胫前、后动脉间有丰富的吻合支和粗大的交通支，最近端交通支距内、外踝连线５．５±０．８（３．６～７．４）ｃｍ，外径１．２±０．３ｍｍ。结论：以腓血管为蒂可以形成比目鱼肌皮瓣；该瓣逆行转位可修复小腿中下段缺损，具有血供可靠、损伤小。

Objective: To provide anatomical basis for the reverse transposition of soleus musculocutaneous flap pedicled with peroneal vessels to repair tissue defect in the middle and low segments of the leg.Methods: The morphology of soleus muscle, the distribution of soleus branches of peroneal artery, and the anastomoses between peroneal artery and anterior and posterior tibial arteries were observed and measured on 6 arterial casts and 33 dissected lower limbs perfused with latex.Results: The soleus branch of peroneal artery is 1～4 in number with the diameter of 2.0±0.5(1.0～3.8) mm.The cutaneous branches arising from it course in soleus muscle or intermuscular septum with their distributive dimension 16 cm×9 cm and the distance between the perforator and fibular head 9.9±3.0 mm .There are plenty of anastomoses and large communication branches between peroneal artery and anterior and posterior tibial arteries.The most proximal communication branch with its diameter 1.2±0.3 mm is 5.5±0.8(3.6～7.4) cm to the line between medial and lateral malleoli.Conclusions:The soleus musculocutaneous flap pedicled with peroneal vessels could be designed and be used for repairing tissue defect in the middle and low part of leg,with the features of reliable blood supply,less injury and simple operation.