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1、·214·CHINESEJOURNALOFCLINICALANATOMYVOL.21NO.32003·应用解剖·胫前动脉踝上皮支皮瓣的显微外科解剖1112张洪权,王江宁,李晋,张高孟(1.大连市中心医院骨外科,辽宁大连116033;2.华山医院手外科,上海200040)【摘要】目的:报道胫前动脉踝上皮支皮瓣的显微外科解剖学基础。方法:在14侧经动脉灌注红色乳胶成人下肢标本,解剖观测胫前动脉踝上皮支的起始、走行、外径、长度及分支等,2侧成人下肢标本灌注墨汁观察该皮支的墨染范围。结果:胫前动脉踝上皮支于踝间连线上方(3.5±0.6)cm自胫前动脉发
2、出,然后向小腿内侧方向绕过胫骨前缘分出升支和降支,升支紧贴胫骨前内侧骨面,向内上方向行至一段距离后穿深筋膜入皮。踝上皮支长(2.1±0.6)cm,起点外径(1.1±0.2)mm,伴行静脉2条。升支入筋膜前外径(0.4±0.1)mm。降支向内下方向走行,并与踝前血管网吻合。结论:胫前动脉踝上皮支是胫前动脉在小腿踝上部的主要皮血管,分支营养骨膜,可在小腿中下段设计以此血管为蒂的皮瓣、骨膜瓣、骨膜皮瓣或骨皮瓣。【关键词】外科皮瓣;胫前动脉;踝上皮支;显微外科解剖【中图分类号】R616.2;R322.121【文献标识码】A【文章编号】1001-165X
3、(2003)03-0214-03MicrosurgicalanatomyoftheflappedicledwithsuperiormalleoluscutaneousbranchofanteriortibialarteryZHANGHong2quan,WANGJiang2ning,LIJin,etal.DepartmentofOrthopedics,CentralHospitalofDalianCity,Dalian116033,China【Abstract】Objecives:Toreportmicrosurgicalanatomybasis
4、foranewflapbasedonthesuperiormalleoluscutaneousbranchoftheanteriortibialartery.Methods:Theorigin,course,diameter,lengthandbranchesofthesuperiormalleoluscutaneousbranchoftheanteriortibiawereobservedon14sidesofadultlowextremityspecimensperfusedwithredlatex.Thebloodsupplyrangeo
5、fthearterywasobservedon2sidesoffreshlowex2tremityspecimensinjectedwithblackink.Results:Thesuperiormalleoluscutaneousbranchoftheanteriorarterywasfoundinallspecimens.Thearteryoriginatedfromtheanteriortibialarteryatthe3.5±0.6cmprox2imaltotheintermalleolus,runsproximallytothetib
6、ialcres,givingoffascendingbranchesnourishingthesofttissueofthesuperiormalleolusanddescendingbranches.Thelengthofthearterywas2.1±0.6cm.Accompa2niedbytwoveins,itsdiameterattheoriginalsitewas1.1±0.2mm.Conclusion:Thesuperiormalleoluscuta2neousbranchoftheanteriortibialarteryisama
7、inbranchoftheanteriortibialarteryatthesuperioranklewithconstantanatomy.Itisoneofthemainnourishingarteriesofskinatthemedialandlowersegmentoftheleg.Differentkindsofflapandcombinedtissueflapcouldbedesignedbasedontheartery.【Keywords】surgicalflap;anteriortibialartery;superiormall
8、eoluscutaneousbranch;microsurgicalanatomy小腿下段及足部创伤、感染、肿瘤等因素所造成的16侧成人新鲜小腿,其中
