筋膜骨膜骨瓣移位术的解剖学基础

Anatomic basis for the transposition of fascio-osteo-periosteal flap

通过动脉灌注红色乳胶,在12个肢体上观察了筋膜骨膜骨瓣的血供规律:①深筋膜有上、下血管网,供血“渠道”有鲜明的纵行方向性,故筋膜蒂应依纵向进行设计;②肌间隔为连接深筋膜与骨膜间的“桥梁”,故可设计为筋膜蒂-肌间隔-骨膜骨瓣;③利用肌间隔内包含的知名轴型血管,可以增加筋膜蒂骨膜骨瓣的长与宽比例;④深筋膜深面与肌肉之间存有筋膜下疏松结缔组织,是手术分离的“外科平面”。

The blood supply of the fascio- osteo-periosteal flap,demonstrated by means of arterial perfusion with red latex on 12 specimens, can be ou- tlined as fullows: 1) the deep fascia is supplied by both the subfascial and the suprafascial arterial plexuses and these plexuses show a marked dire- ctionality. Therefore, the long axis of the flap needs to be oricntated along the predominating directiona- lity of the fascial arterial plexuses; 2)the intermuscular septum serves as a bridge linking the deep fascia and the periosteum, by which a kind of fascio-septo-periosteal flap or fa- scio-septo-osteo-periosteal flap can be formed;3) the large axial blood vessels in the intermuscular septum provide sufficient blood for the flap; and 4) the loose connective tissue between the deep fascia and the un- derlying muscles may be regarded as the surgical plane for operative sep- aration.