带血管蒂的足内侧复合组织瓣局部转位术的应用解剖

Anatomical Study for the Transposition of Vascularized Compound Tissue Flap of Medial Pedal

目的:为一期修复踝足部的复合组织缺损提供一种足内侧复合组织瓣。方法:利用40侧动脉灌注红色乳胶的成人足标本,解剖观察足内侧区动脉来源、口径、走行、分支及分布情况;3侧新鲜足标本观测复合瓣的大小及摹拟转位手术。结果:内踝前动脉、跗内侧动脉及足底内饲动脉深、浅支在走行中分别发出若干皮支、肌支和骨膜支供血足底内侧区诸结构,且相互问形成广泛、恒定的吻合,连同其相伴的静脉和神经共同形成带血管蒂的足内侧复合组织瓣。结论:带血管蒂的足内侧复合组织瓣可转位一期修复踝足部的复合组织缺损,该瓣血管多元化,转位灵活,不牺牲主要血管,手术简便安全,可一期同时修复多种组织缺损。

Objective: To provide a design of transposition of vascularized compound tissue flap of medial pedal for repairing compound tissue defect of malleolus and pedal. Methods:On 40 adult cadaveric lower limber specimens injected with red dye, the origin,diameters,course,branchs,and distribution in the area of medial pedal were observed;on another three fresh cadaveric pedal specimens, the size of compound tissue flap were measured and transposition was imitated. Results:The medial anterior malleoulus artery, the medial tarsal artery, the profound branch and superficial branch of meidal plantar artery have skin branchs, muscular branchs and periosteal branchs during their course of extension. They form widespread and constant vessels network in the area of medial pedal and the vascularized compound tissue flap of medial pedal is commonly formed with concomitant vein and nerve. Conclusion:The transposition of this kind of compound tissue flap pedicled with any of afore mentioned arteries can be used to repair complex and compound defect of malleolus and pedal, the characteristics of this compound tissue flap are as follows the vessel is diversified, the flap is easy to transfer, the major vessels are preserved, the operatio is secure and simple and it can be used to repair compound and complex tissue defect.