摘要
目的为旋股外侧动脉斜支穿支皮瓣的临床应用提供解剖学依据。方法选用新鲜成人尸体标本52具,一次性全身血管造影与MDCT扫描,经Mimics图像工作站重建。由浅至深行3D层次解剖,重点观测旋股外侧动脉血管树的立体结构。结合3D视图,在整体标本上按照临床皮瓣设计与切取步骤行层次解剖,测量记录斜支的发出部位、起始部外径、行程、血管蒂长及与肢体纵轴成角等。结果104侧标本中4侧显影不良,100侧有效标本中斜支出现率为65%(65/100),起始处外径(2.0±0.9)mm,长度(13.0±6.5)cm。走行方向自内上斜向外下,与肢体纵轴成角20°~60°,并有穿支发出。结论旋股外侧动脉斜支浅出点多数位于以髂-髌线中点以近8 cm为圆心,半径4 cm的外侧半圆形区域内,可以此区域内穿支为蒂设计旋股外侧动脉斜支穿支皮瓣。
Objective To provide an anatomical basis for the clinical application of the oblique branch perforator flap of the lateral circumflex femoral artery.Methods Fifty-two fresh adult cadaver specimens were selected for one-time whole-body vascular angiography and MDCT scanning,followed by reconstruction using the Mimics imaging workstation.Three-dimensional(3D)layered dissection was performed from superficial to deep layers,with a focus on the stereoscopic structure of the vascular tree of the lateral circumflex femoral artery.Combined with 3D visualization,layered dissection was conducted on the entire specimens according to the clinical flap design and harvesting procedures.The origin,external diameter at the initial point,course,length of the vascular pedicle,and the angle relative to the longitudinal axis of the limb were measured and recorded for the oblique branch.Results Among the 104 sides of the specimens,4 sides showed poor imaging and 100 sides were valid.The oblique branch was present in 65%(65/100)of the valid specimens,with an external diameter of(2.0±0.9)mm at the origin and a length of(13.0±6.5)cm.The oblique branch coursed from superomedial to inferolateral,forming an angle of 20°~60°with the longitudinal axis of the limb,and gave off perforating branches.Conclusions The superficial emergence point of the oblique branch of the lateral circumflex femoral artery mostly locates within a lateral semicircular region centered 8 cm proximal to the midpoint of the iliac-patellar line,with a radius of 4 cm.Perforators within this region can be used as the pedicle for designing the perforator flap of the oblique branch of the lateral circumflex femoral artery.
作者
张兴
唐举玉
吴攀峰
卿黎明
符劲飞
孙念哲
周小兵
王志
Zhang Xing;Tang Juyu;Wu Panfeng;Qing Liming;Fu Jinfei;Sun Nianzhe;Zhou Xiaobing;Wang Zhi(Department of Hand and Microsurgery,Pingdingshan Zhanhe Orthopedics Hospital,Pingdingshan 467009,Henan Province,China;Department of Orthopedic,Hand and Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,Hunan Province,China;Human Morphology Experimental Center,Hengyang Medical School,University of South China,Hengyang 421001,Hunan Province,China)
出处
《中国临床解剖学杂志》
北大核心
2025年第5期511-519,共9页
Chinese Journal of Clinical Anatomy
基金
国家自然科学基金(81871577)
骨科-国家临床重点专科建设经费(Z047-01)。
关键词
旋股外侧动脉
斜支
三维重建
层次解剖
Lateral circumflex femoral artery
Oblique branch
3D reconstruction
Layered anatomy
