前锯肌瓣乳房再造或丰乳术的应用解剖

Applied anatomy of serratus anterior muscutaneous flap for breast reconstruction or swelling

目的 :为应用前锯肌瓣乳房再造术或丰乳提供形态学依据。方法 :在 3 2具成人尸体观测了前锯肌第 2～ 7肌齿的长、起、中、止点的宽、厚及肌的起点距前正中线和锁骨中线的距离以及血管、神经等。结果 :①前锯肌的第 3、4、5、6齿复合瓣的长度 ,起、中、止点宽度和厚度分别为 15 9.6,94.4、80 .4、5 2 .8mm和 3 .5、5 .8、9.3mm。②第 3、4、5、6齿复合瓣距前正中线和锁骨中线的距离分别为 10 6.9mm和 40 .0mm。③肌由胸长神经和肋间神经外侧支双重支配 ,其前上部由胸外侧动脉、后下部由胸背动脉供应。结论 :前锯肌的第 3、4、5或 6齿从形态上可以用于丰乳或乳房再造术 ,保留肌的第 1、2齿和第 6以下肌齿既可以防止“翼状肩”的发生又可以使肩胛骨保持旋转功能。

Objective: To provide morphological data of serratus anterior muscle for breast reconstruction or swelling. Methods: 32 preserved adult cadavers were dissected. The whole length, width and thickness of the origin, middle, end point of serratus anterior muscle (2nd to 7th gear), distance from the origin point to anterior median line and midclavicular, arteries and nerves were observed. Results: 1. The length, width and thickness of the origin, middle and end point of the 3 rd～6 th gear complex of serratus anterior muscle were 159.6 mm, 94.4, 80.4, 52.8 mm and 3.5, 5.8, 9.3 mm. 2. The distance to the anterior median line and midclavicular of the 3rd ～6th gear complex were 106.9 and 40.0 mm. 3. serratus anterior muscle was double-controlled by long thoracic nerve and the lateral branches of intercostals nerve. The anterior upper part of it was mainly supplied by lateral thoracic artery, and the poserior lower part of it was supplied by thoracodorsal artery. Conclusion: The 3rd, 4th, 5th, or 6th gear of serratus anterior muscle can be used for breast swelling or reconstruction. The reserving 1st, 2nd and lower gear from 6th may avoid the appearance of the 'wing shoulder' and keep the rotation of scapula.