股后皮神经营养血管皮瓣的临床应用

Clinical application of posterior femoral cutaneous neurovascular flap

目的探讨股后皮神经营养血管蒂皮瓣的解剖特点与临床应用疗效。方法自1999年～2003年,在10侧经动脉灌注红色乳胶成人新鲜下肢标本中,解剖观测股后皮神经血供及其筋膜皮支的分布范围,并设计应用股后皮神经营养血管蒂皮瓣修复腘窝、髋关节周围软组织缺损12例。结果股后皮神经营养血管主要来源臀下动脉和腘(股)动脉后侧穿支的升皮支,并在股后区形成网状吻合营养股后侧皮肤。本组皮瓣11例全部成活,仅1例皮瓣远端少量坏死,换药后愈合。经2～50个月随访,皮瓣无破溃,膝、髋关节功能良好。结论股后皮神经营养血管蒂皮瓣是一种修复腘窝、髋关节周围软组织缺损较好的方法。

Objective To study the anatomical basis and effect of the posterior femoral cutaneous neurovascular flap.Methods From November1999to July2003,10side of fresh adult lower limb specimens perfused with red latex were dissected to identify the nutrient vessels of the posterior femoral cutaneous nerve(PFCN)and other cutaneous perforators on the posterior aspect of the lower thigh.Based on the anatomic study,the flap pedicled with nutrient vessels of PFCN was devised to repair the soft tissue defects around the knee and hip in12patients clinically.Results The nutrient vessels of PFCN were the branches from the inferior gluteal artery and the ascending cutaneous branch of the popliteal artery.These nutrient vessels sent many cutaneous branches and anastomosised at the posterior femoral skin.12patients were satisfactorily treated.Followed up for2-50months,the function of joint in patients were excellent.Conclusion The posterior femoral cutaneous neurovascular flap is an effective and feasible operative method for repairing the soft tissue defects of popliteal fossa and around hip.