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目的为股内侧肌穿支蒂股中间皮神经营养血管皮瓣提供解剖学基础。方法在30侧动脉内灌注红色乳胶的成人下肢标本上,以髌骨中点、收肌结节为观测标志解剖观测:①股中间皮神经走行与分布;②股内侧肌穿支与股中间皮神经营养血管间的吻合关系。另用1侧新鲜标本进行摹拟手术。结果①股中间皮神经前支体表投影相当于腹股沟韧带中点与髌结连线(髌骨中点至收肌结节的连线)中点的连线;②股内侧肌穿支穿出点位于股内侧肌支体表投影线(腹股沟中点与收肌结节连线中、下1/3交界点至髌骨中点的表线)中点附近,相当于收肌结节上(9.4±2.4)cm、髌骨中点垂线内(4.1±1.0)cm处。穿支穿过深筋膜至皮下,并分出众多的细小血管与股中间皮神经的神经旁和神经干血管链(网)密切吻合,在大腿前内侧形成顺沿股中间皮神经纵轴的血管丛。结论可形成股内侧肌穿支蒂股中间皮神经营养血管皮瓣转位修复膝部软组织缺损术式。
Objective To provide an anatomical basis for medial femoral cutaneous neurocutaneous flap. Methods Anatomical observation was made on the adult lower extremities with 30 sides of the artery infused with red latex. The midpoint of the patella and the muscular nodules were observed and observed. ① The medial branchar nerve was walked and distributed; Anastomosis between nutrient vessels. Another 1 side of the fresh specimens were simulated surgery. Results ① The projection of the medial anterior branch of the medial nerve was equivalent to the midpoint between the midpoint of the inguinal ligament and the midpoint of the patellar knot (the connection between the midpoint of the patella and the branch of the adductor muscle); Median midpoint of the line of medial muscularis propria projection (the middle of the groin midline and the adductor muscle nodus, the lower third of the junction to the midpoint of the patella) 2.4) cm, midpoint of the patella (4.1 ± 1.0) cm. Perforation of the deep fascia through to the subcutaneous subcutaneous and divided into numerous small blood vessels and the middle of the femoral nerve nerve and neural stem adjacent to the vascular chain (mesh) close to the formation of the anteromedial thigh along the medial cutaneous nerve axis Vascular plexus. CONCLUSIONS: It is possible to form the knee soft tissue defect by transposition of the medial cutaneous neurocutaneous flap pedicled with medial femoral muscle.