膝降血管髌下支蒂胫骨骨膜瓣移位修复膝关节面的应用解剖

Applied anatomy of the medial tibial periosteal flap pedicled with the inferior patellar branch of descending genicular vessels for repair of genicular articular surface

目的 :为用膝降血管髌下支蒂胫骨骨膜瓣移位修复膝关节面病损提供解剖学依据。方法 :用 30侧经动脉红色乳胶灌注的成人下肢标本 ,解剖观测膝降动脉髌下支起始、位置、至胫骨内侧面的分支、分布和吻合。结果 :膝降动脉髌下支沿大收肌腱板和收肌结节前面下行 ,至膝关节间隙水平向前横行于关节囊表面 ,由此向下发 2～ 5支胫骨骨膜支。这些骨膜支与膝下内侧动脉和隐动脉等动脉的胫骨骨膜支相互吻合 ,分支分布于胫骨内侧面。结论

Objective:To provide anatomical basis for transposition of the medial tibial periosteal flap pedicled with the inferior patellar branch of the descending genicular vessels for repair of genicular articular surface.Methods:The origins,courses,branches and anastomosis of the inferior patellar of the descending genicular arteries were observed on 30 adult cadavers perfused with red latex.Results:The inferior patellar of the descending genicular arteries desended from the surface of adductor muscle tendon and adductor tubercles and then crossd the surface of the articular capsule at the level of articular space.The inferior patellar branches gave off 2～5 tibial periosteal branches.These branches anastomosed with perosteal branches of the medial inferior genicular arteries and saphenous arteries to supply the superior and middle parts of medial tibial periosteum.Conclusion:The medial tibial periosteal flap pedicled with the inferior patellar branches can be transposed for the treatment of the defect of genicular articular surface.