论文部分内容阅读
目的：探讨以肌间隔皮支为蒂外踝上皮瓣的解剖学基础，为临床提供新的皮瓣供区。方法：在３６侧灌注红色乳胶或墨汁的成人下肢标本上，对小腿下部后外侧皮肤的血供及皮神经分布等进行了较系统的应用解剖学观测。结果：腓动脉在拇长屈肌覆盖下沿腓骨的内后方下行，于内、外踝之间穿出骨间膜之前远端分别发出跟外侧动脉和胫后动脉吻合支；其在下１／３开始处的外径为（２．３±０．５）ｍｍ，伴行静脉有两条。该动脉在小腿下部下行过程中，除分支至邻近肌肉和腓骨外，其皮支按其长度＞６．５ｃｍ和外径＞０．７ｍｍ而分为两种类型：①肌间隔皮支主干型，占６９．４％。由腓动脉在距外踝向外最突点上方（１２．４±１．８）ｃｍ处发出，起点外径为１．２±０．２ｍｍ，长度８．８±１．６ｃｍ。由于它由腓动脉发出后即沿肌间隔向下斜行，行程较长，沿途还发出２．２±０．７个分支，故本文将其命名为肌间隔降支。②肌间隔皮支分散型，占３０．６％，分别出现２～４支不等。腓肠神经多数由腓肠内侧和外侧皮神经的交通支吻合而成，该型在本文测得占８２．９％，吻合处距外踝（１５．４±４．５）ｃｍ，横径（２．９±１．０）ｍｍ。二者不吻合的为１７．１％。根据小腿下部后外侧皮肤墨汁灌注透明观察，可清?
Objective: To explore the anatomic basis of the lateral malleolus flap with the musculocutaneous branch and provide a new flap for the clinical. Methods: An anatomical study of the blood supply and the distribution of cutaneous nerves in the posterolateral skin of the lower leg was performed systematically on the adult lower extremities implanted with red latex or ink on the 36 sides. Results: The peroneal artery descended along the posterior fibular within the coverage of the flexor hallucis longus, and anastomosed branches of the lateral artery and tibiofemoral artery were produced at the distal ends of the interosseous and medial malleolus. Department of the outer diameter of (2.3 ± 0.5) mm, accompanied by two veins. The artery in the lower leg lower descending process, in addition to the branch to the adjacent muscles and fibula, the skin branch according to its length> 6.5cm and outer diameter> 0.7mm and divided into two types: ① muscular intercostal branch trunk type, Accounting for 69.4%. From the peroneal artery in the outskirts of the most prominent point (12.4 ± 1.8) cm Department issued, the starting point of the outer diameter of 1.2 ± 0.2mm, length 8.8 ± 1.6cm. Because it is issued by the peroneal artery that is oblique down along the intermuscular interval, a longer stroke, along the way also issued 2.2 ± 0.7 branches, so this article will be named myotube descending. ② muscular intercostal branch scattered type, accounting for 30.6%, respectively, ranging from 2 to 4 months. Most of the sural nerve sural nerve by the medial and lateral branch of the traffic branch anastomosis, the type measured in this article accounted for 82.9%, anastomosis from the lateral malleolus (15.4 ± 4.5) cm, diameter (2 .9 ± 1.0) mm. The two do not match 17.1%. Under the lower part of the lower leg skin ink perfusion transparent observation, clear?