腓肠内侧动脉穿支皮瓣解剖学研究

Anatomic study of medial sural artery perforator flap

目的探讨腓肠内侧动脉穿支的解剖规律和特点,为该皮瓣的临床应用提供解剖学依据。方法 2010年4月至2011年4月于北京大学医学部对10侧下肢标本的腓肠内外侧动脉穿支进行解剖测量。收集2010年7月至2011年4月北京大学口腔医院颌面外科行腓肠内侧动脉穿支皮瓣手术14例患者的穿支位置和数目数据。结果尸体解剖结果显示,腓肠内侧动脉穿支数目中位数为2.5支(1~6支);穿支距腘纹5.0~19.0 cm,距小腿后正中线1.0~6.0 cm;临床应用解剖显示,穿支数目中位数为2.0支(0~4支);穿支距腘纹线5.0~19.0 cm,距小腿后正中线0~5.8 cm。消除小腿长度影响发现,穿支多数分布于小腿上1/5~1/3之间。结论腓肠内侧动脉穿支数目较恒定,位置恒定,血管蒂长,适合临床设计穿支皮瓣使用。

Objective To study the anatomic features of medial sural artery perforator flap and provide anatomic evidence for its clinical application.Methods Totally 10 lower limbs preserved in formaldehyde from cadavers of adults were used to observe the anatomy of medial and lateral sural artery.Between April of 2010 and April of 2011,14 clinical cases were reconstructed by using medial sural artery perforator flap,perforator data were collected.Results In all 10 specimens the mean number：median of total perforators was 2.5 （ranging 1 to 6）.All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 1.0 cm and 6.0 cm from the midline of the gastrocnemius muscles.In clinical study,the mean number：median of total perforators was 2.0（ranging 0 to 4）.All perforators were in an area between 5.0 cm and 19.0 cm from the popliteal crease and between 0 cm and 5.8 cm from the midline of the gastrocnemius muscles.Most perforators entered the medial gastrocnemius muscle at a relative distance of one-fifth to onethird of the lower leg length measured from the popliteal crease.Conclusion The medial sural artery perforator flap provides a constant anatomy with a long pedicle.It is a good alternative for oral and maxillofacial reconstruction of defects.