外踝上皮瓣皮支来源的解剖学研究和临床意义

Origin of cutaneous branch of lateral supramalleolar flap: anatomy and clinical significance

目的研究外踝上皮瓣皮支的起源,为临床应用提供解剖学依据。方法对30侧红色乳胶灌注的新鲜下肢标本进行解剖,对8例接受外踝上皮瓣修复的患者进行术中观测,记录外踝上皮瓣皮支的起始位置、相关动脉外径等数据。结果 30侧标本中有22侧(73.3%)以及8例手术患者中有5侧的外踝上皮瓣皮支起自腓动脉和胫前动脉在下胫腓联合近侧的动脉弓,另有8侧标本(26.7%)和3侧手术患者的皮支起自腓动脉的骨间膜终末穿支或腓动脉主干。结论外踝上皮瓣皮支主要起自腓动脉和胫前动脉在下胫腓联合近侧的动脉弓,临床应用该皮瓣时应注意明确皮支的起源。

Objective To study the origin of the cutaneous branch of lateral supramalleolar flap,and provide anatomic basis for the related clinical applications.Methods 30 fresh cadaver legs injected with red latex were dissected,and 8 patients receiving repair of the lateral supramalleolar flap were observed.Anatomic data,including the origin of the cutaneous branches and the outer diameter of related arteries were collected and analyzed.Results 22 out of 30 cadaver legs（73.3%） and 5 out of 8 patients were found that the cutaneous branch of lateral supramalleolar flap arose from the arterial arch between the anterior tibial artery and the peroneal artery,which was proximal to the inferior tibiofibular syndesmosis.The cutaneous branch of the another 8 specimens（26.7%） and 3 patients arose from the perforating branch of the peroneal artery or from the peroneal artery directly.Conclusions The cutaneous branch of the lateral supramalleolar flap mainly arises from the arterial arch between the anterior tibial artery and the peroneal artery,and the origin of the cutaneous branch should be identified during the surgery treating.