足内侧穿支皮瓣的解剖学研究与临床应用

Anatomy and Clinical Application of Medialis Pedis Perforator Flap

目的：探讨足内侧穿支皮瓣的应用解剖及其修复手足部软组织缺损的临床效果.方法：10侧成人足踝标本经胫后动脉注入红色乳胶液,解剖观测足底内侧动脉穿支血管在足内侧区的分布、起源等.临床设计足内侧穿支皮瓣修复手足部软组织缺损19例,软组织缺损面积2 cm×2 cm～10 cm×6 cm.结果：足底内侧动脉向（足母）展肌和舟楔骨间隙内发出2支相对恒定的穿支血管,供养足内侧穿支皮瓣.19例皮瓣完全成活,皮瓣面积2 cm× 3 cm～11 cm×8 cm.随访3 ～ 26个月,皮瓣质地优良,外形与功能恢复满意,供区愈合良好.结论：以足底内侧动脉穿支血管营养的足内侧穿支皮瓣血供可靠,质地优良,是修复足踝及手部软组织缺损的良好选择.

Objective：To investigate the applied anatomy of medialis pedis perforator flap, and report its clinical results of repairing the defects of aeromelie soft tissues. Methods：The origin, course, distribution and outside diameter of the perforators of medial plantar artery were observed by infusing red emulsion into the posterior tibial arteries in 10 adult eadaveric specimens. Clinically, 19 medialis pedis perforator flaps were used to repair the defeetive soft tissues on hands, feet and ankles. The defective areas ranged from 2 cm × 2 cm to 10 cm × 6 cm. Results： Medial plantar artery sent two permanent perforating branched towards abduetor hallucis musele and the septum between scaphoid bone and medial cuneiform hone. These perforators supplied the medialis pedis perforator flap. All 19 niedlalis pedis perforator flaps survived uneventfully. The flap areas ranged from 2 cm× 3 ×m to 11 cm × 8 cm. The appearance and functional results were satisfactory during 3 - 26 months follow up. Conclusions：The medialis pedis perforator flap which supplied by the perforating branches of medial plantar artery possesses reliable blood supply and fine texture, is suitable for repairing defective soft tissues on hands, feet and ankles.