摘要
目的探查足内侧血管分布的解剖学特点，以及不同血管蒂皮瓣用于修复足踝部创伤的效果。方法成人下肢标本共30侧，经胭动脉或胫后动脉灌注红色乳胶，解剖观测足内侧皮肤的动脉来源、分支、分布及吻合。据此切取内踝前穿支皮瓣及远端蒂足内侧皮瓣对临床16例足踝部创伤患者进行修复。结果足内侧皮肤血管来源存在多样性，其主要有内踝前动脉、跗内侧动脉及二者发出的前后支与躅趾底动脉浅支和足底内侧动脉浅支吻合而成的动脉弓。依据前二者动脉分布区域的大小，可将足内侧皮肤的血管解剖分为三种类型。临床16例皮瓣全部存活，随访2周～20个月，皮瓣色泽正常，外观良好，有痛温觉。结论切取内踝前穿支皮瓣可以很好地修复踝周皮肤软组织缺损，而切取远端蒂足内侧皮瓣可以很好地修复中前足部皮肤软组织缺损。
Objective To investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma. Methods Thirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin, branches, distribution and anastomosis of the medial foot. Then, anterior medial malleolar artery perforator flaps and distafly-based medial foot flaps were har- vested and used for repairing foot and ankle trauma of 16 patients. Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery, medial tarsal artery, and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery. According to distribution area of the anterior medial malleolar artery and the medial tarsal artery, the vascular anatomy of the medial foot skin was classified into three types. Clinically, all the flaps survived. Follow-up ranged from 2 weeks to 20 months, which showed normal color, good shape and good pain and warm sensation of the flaps. Conclusion The anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle, whereas the distally-based medial foot flaps present good recon- struction of soft tissue defects of the mid-forefoot.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2012年第10期933-936,共4页
Chinese Journal of Trauma
基金
温州市科学技术局资助项目（Y20080125）
关键词
足损伤
踝损伤
外科皮瓣
血管解剖
Foot injuries
Ankle injuries
Surgical flaps
Vascular anatomy
