腓肠外侧皮神经营养血管岛状筋膜皮瓣的解剖学基础

The anatomical bases of the island fasciocutaneous flap pedicled with nutrient vessels of the lateral sural cutaneous nerve

目的 :为腓肠外侧皮神经营养血管岛状筋膜皮瓣提供解剖学依据。方法 :采用巨微解剖、全身动脉放射显影及电脑图像分析技术 ,解剖观察了腓肠外侧皮神经及其营养血管的起始、走行、分支与分布情况。结果 :腓肠外侧皮神经于腓骨头上方 ( 7.1± 1.3 )cm ,中线外侧 ( 1.8± 0 .6)cm起自腓总神经 ,分支分布于小腿后外侧上 2 /3部 ,末端与腓肠内侧皮神经相吻合。其营养动脉主要为窝外侧皮动脉 ,于腓骨头水平面上方 ( 4 .6± 2 .3 )cm处发自动脉 ,并于腓骨头上 ( 4 .6± 1.2 )cm ,中线外侧 ( 2 .1± 0 .5 )cm处开始伴行腓肠外侧皮神经下降 ,下端主要与腓动脉穿支吻合 ,形成一营养血管链。结论 :以腓肠外侧皮神经及其营养血管链为蒂可以设计近端或远端蒂岛状筋膜皮瓣。

Objective: To provide anatomical basis for the island fasciocutaneous flap pedicled with nutrient vessels of the lateral sural cutaneous nerve. Methods: Microsurgical anatomy and radiograph were made in 35 lower limbs to sum up the origins, courses, branches, distribution and anastomosis of the lateral sural cutaneous nerve and its nutrient vessels. Results: The lateral sural cutaneous nerve arised from the common peroneal nerve 7.08±1.29 cm above the level of the head of fibula, and 1.79±0.60 cm lateral of the midline of the leg. It was distributed over the superior part of the posterolateral leg, and it anastomose to the medial sural cutaneous nerve in the end. Its main nutrient vessal was the lateral popliteal cutaneous artery. It arised from the popliteal artery 4.62±2.34 cm above the level of the head of fibula, and accompanieed to the lateral sural cutaneous nerve on the point 4.60±1.20 cm above the head of fibula, and 2.05±0.46 cm lateral of the midline. On the superomiddle of the leg, the lateral popliteal cutaneous artery anastomosed to the perforaters of the peroneal artery and form a chain-linked cutaneous neurovascular plexus. Conclusion: the island fasciocutaneous flap pedicled with nutrient vessels of the lateral sural cutaneous nerve can be developed reversed or sequencely.