腓浅神经及终支皮神经营养血管皮瓣的解剖基础测量

Neurocutaneous flaps in superficial peroneal nerve and the cutaneous nerve:Anatomic measurement

目的为腓浅神经及终支皮神经营养血管皮瓣设计提供解剖学依据。方法选择20侧成人下肢标本,观察并测量腓浅神经及其终支皮神经营养血管的起源、走行以及分布情况。结果腓浅神经起源于腓骨头外侧下方的腓总神经,浅出于腓浅神经后在踝关节的前上方分为两支:足背内侧皮神经和足背中间皮神经。腓浅神经的分支处距离AF连线近远侧的比例分别为[(22.7±1.9)/(31.33±1.8)]%和[(8.63±0.97)/(31.33±1.8)]%;腓浅动脉起始点的动脉直径为(1.07±0.28)mm。腓浅动脉于腓骨头的下方(147.61±29.68)mm处浅出,分布于小腿下部的前外侧皮肤。足背内侧皮神经于J点外侧横径为(1.9±0.3)cm,主干长度为(2.8±0.9)cm,在AF线的下方(2.9±0.3)cm分为内侧支和外侧支。足背中间皮神经于J点外侧横径为(1.7±0.5)cm,主干长度为(2.9±0.5)cm,在AF线的下方(3.1±1.1)cm分为内侧支、中间支和外侧支。结论腓浅神经及终支皮神经营养血管分支、分布基本恒定,与邻近的肌、皮肤营养血管同源,可以提供局部较大面积的神经营养血管皮瓣。

Objective To provide anatomic data by anatomically measuring neurocutaneous flap on superficial peroneal nerve and artery with their terminal branches. Methods A total of 20 adult cadaver lower limb specimens were perfused with red latex. The origin, course and distribution of peroneal nerve and artery with their branches were observed. Results The superficial peroneal nerve was originated from common peroneal nerve at lateral side of fibular head, then branched into two terminal branches at anterosuperior the ankle joint： cutaneous dorsalis medialis and lateralis nerve.The proportion of proximal side and distal side from bifurcation of superficial peroneal nerve to the AF link line was[（22.7±1.9）/（31.33±1.8）]%, [（8.63±0.97）/（31.33±1.8）]% of distal side, respectively. The diameter of superficial peroneal artery origin was（1.07±0.28） mm. The superficial peroneal artery was gave off a superficial branch from（147.61±29.68）mm below fibular head, which distributed in the anterolateral skin of the lower part of leg. The diameter of cutaneous dorsalis medialis nerve at the lateral side of J point was（1.9±0.3） cm, and its main trunk was（2.8±0.9） cm in length. It branched into medial and lateral branches（2.9±0.3） cm below AF link line. The intermediate dorsal cutaneous nerve lateral J point was（1.7±0.5） cm, and its main trunk was（2.9±0.5） cm in length. Medial, intermediate and lateral branches were branched below（3.1±1.1） cm AF link line. Conclusion The branches and distribution of superficial peroneal nerve and artery with their branches are mainly constant. They have the same origination with adjacent nutrient blood vessels of muscles and skin, which can provide the large area of neurocutaneous flap.