小腿穿支皮瓣的应用解剖

Anatomic study of perforator flaps in lower leg

目的:探讨小腿穿支血管的应用解剖。方法:成人下肢标本10侧,用乳胶进行腘动脉灌注,解剖观察腓动脉及胫后动脉穿支的数量和走行,并以内外踝尖的连线标志定位穿支血管,绘制穿支血管分布图。结果:腓动脉沿途发出(5.3±0.8)支穿支血管,主要从外侧肌群、外侧肌间隔以及后外侧肌群穿出,集中在距外踝5～10cm及21～27cm这2个区段内。胫后动脉发出(5.6±0.3)支穿支血管,主要从内侧肌群、内侧肌间隔以及后内侧肌群穿出,多集中在距内踝6～8cm、13～18cm以及23～27cm这3个区段内。小腿深部源动脉的穿支血管均参与了皮神经营养血管丛的形成。结论:提供了小腿穿支皮瓣的血管解剖数据,为临床设计应用穿支皮瓣提供解剖学依据。

Aim： To investigate the anatomy applied in perforator vessel in the lower leg. Methods： Popliteal artery of 10 adult cadaver lower limb specimens was infused with latex. Quantity and run of peroneal artery and posterior tibial artery were observed,and perforating vessels were located with attachment sign between inner and outer ankle,and the allocation plan was drawn. Results： There were （ 5. 3 ± 0. 8） perforator vessels originated from the peroneal artery via lateral muscles and the intermuscular septum between them,and reliable perforator vessels were found in the two distinct intervals： 5 ～ 10 cm and 21 ～ 27 cm near to external malleolus. There were （ 5. 6 ± 0. 3） perforator vessels originated from the posterior tibi-al artery via medial muscles and the intermuscluar septum between them,and reliable perforator vessels were found in the three distinct intervals： 6 ～ 8 cm,13 ～ 18 cm and 23 ～ 27 cm near to medial malleolus. Perforating vessels originated from deep calf were engaged in the formation of the nutrient vessels of cutaneous nerve plexus. Conclusion： The detailed vascu-lar anatomy data of perforator flap are obtained,which could provide anatomic data for harvesting potential perforator flap as a donor site.