三角肌的血供特点及临床意义

The characteristics of blood supply of detoid muscle and its applied anatomy

目的 :为临床应用三角肌皮 (骨 )瓣提供应用解剖学基础。方法 :5 0侧成人上肢标本 ( 10侧动脉铸型标本 ) ,观察三角肌形态、血供来源、分布特点及神经支配 ;2例新鲜上肢标本经锁骨下动脉灌注含有银珠粉的显影剂 ,X线拍片 ,观察动脉在三角肌内的分布、构筑特点。结果 :三角肌前部肌束血供来源于胸肩峰动脉的三角肌支和肩峰支 ,其血管神经束在肩峰角下 5 .6cm入肌 ;中后部肌束血供主要来源于旋肱前动脉和旋肱后动脉 ;三角肌由腋神经支配 ,其主干的体表投影位于肩峰平面下方 ( 5 .3± 1.7)cm ;三角肌后缘前方 ( 4 .2± 1.2 )cm和肩峰前角与三角肌粗隆连线后方 ( 1.3± 1.1)cm处。结论 :三角肌血供丰富为多源性 ,血管径粗、蒂长、体表易定位 ,有神经伴行 ,可以制成带感觉的肌皮骨瓣用以修复软 (骨 )

Objective: To supply the basis of applied anatomy for the clinical application of detoid muscle (bone) flap. Methods: 50 examples of adult upper limb specimens(10 artery cast specimans) were observed the figure, the origin of blood supply , the characteristics of distribution and the innervation of the detoid muscle. 2 fresh specimens of upper limb were perfused through arteria subclavia with the developer containing Vermilion power and studyed the characteristics of the distribution, structure of the arteria in the detoid muscle under the optical microscope after being taken by X-ray. Results: The detoid muscle could be divided into three muscle bundle according to the direction and the initial point of its fibers: the anterior, the middle and the posterior muscle bundle .The blood supply of the anterior muscle bundle mainly originated from the detoid branch and the caromial branch of thoracoacromical arteria and entered muscle bilum about 5.6 cm under the acromial angle accompanied with its nerve tracts. The blood supply of the middle and posterior muscle bundles were mainly came from anterior humeral circumflex and post humeral circumflex arteria. The detoid muscle received innervation from axillary nerve which projected its main trunk under the acromial plane about 5.3±1.7 cm, the head of posterior border of the detoid muscle about 4.2± 1.2 cm, and the back of the connecting line between the anterior angle of acromion and the tuberosity of the detoid muscle about 1.3± 1.1 cm. Conclusions: The blood supply of the detoid muscle is abundant and multioriginal. The blood vessels are rather long and wide in diameter following long pedicle and easy to locate from the body surface. It is concomitant with nerves. The detoid muscle can be made into the muscle-bone flap carrying senseation function to repair cartilage tissue defects.