股直肌内神经血管解剖研究和临床意义

The neurovascular anatomy and its clinical implication of the rectus femoris muscle

目的 详细了解股直肌内神经血管解剖分布 ,评价该肌肉能否被分成两个功能单位 ,以提供新的功能性骨骼肌游离移植供区。方法 解剖经双侧股动脉内灌注改良氧化铅—明胶混合液的 10具新鲜尸体及 10具甲醛浸泡的尸体共 40条成人股直肌。结果 40条股直肌肌肉内外血管分布呈现 3种不同类型。 12 5 %的股直肌仅接受 1支动脉供应 ;80 %的肌肉由 1支优势动脉和 1～ 2支次要动脉供应 ;7 5 %的肌肉含有 2支大小接近的优势动脉。股直肌的神经支配来自股神经后束发出的神经支。该支在进入肌肉之前常分成 2支 ,分别有动脉伴行构成神经血管束。结论 根据股直肌内神经血管供应类型以及肌肉内特有的肌腱组织 ,可将该肌分成 2个功能单位 ,供节段性游离肌肉移植。

ObjectiveThe objective of this anatomic study was to investigate the intramuscular neurovascular configuration and to evaluate whether the muscle could be split into two functional units in transplantation. Methods Ten fresh cadavers and ten preserved cadavers were used in the study. A mixture of lead oxide, gelatin and water was injected to the femoral artery of the fresh cadaver. The rectus femoris muscle with its neurovascular pedicles was dissected and radiographed. Results Three vascular patterns of the rectus femoris muscle were found in the 40 cadaver legs. The muscle received its blood supply through a single vascular pedicle (12.5%), or a dominant pedicle with 1～2 ramified (80%), or two dominant vascular pedicles (7.5%). ConclusionsThe study provided a detailed description on the intramuscular neurovascular territories of the rectus femoris muscle. Based on the neurovascular supply of the muscle, it is possible to subdivide the muscle into two functional units for segmental muscle transfer.;