穿支蒂足背中間皮神經(jīng)營養(yǎng)血管皮瓣的解剖基礎(chǔ)
發(fā)布時(shí)間:2018-06-20 18:28
本文選題:足底弓第足背穿支 + 足背中間皮神經(jīng) ; 參考:《中國臨床解剖學(xué)雜志》2016年06期
【摘要】:目的為穿支蒂足背中間皮神經(jīng)營養(yǎng)血管皮瓣修復(fù)前足軟組織缺損提供解剖基礎(chǔ)。方法在30側(cè)動脈內(nèi)灌注紅色乳膠的成人足標(biāo)本上解剖觀測:1足背中間皮神經(jīng)的走行與分布;2足底弓第3足背穿支及其與足背中間皮神經(jīng)營養(yǎng)血管間吻合關(guān)系。另在1側(cè)新鮮標(biāo)本上進(jìn)行摹擬手術(shù)設(shè)計(jì)。結(jié)果 1足背中間皮神經(jīng)主要為腓淺神經(jīng)外側(cè)支的延續(xù),經(jīng)十字韌帶表面,徑直前行至第4跖骨間隙近端附近分為第3、4跖背支,分布于部分足背和趾背皮膚;2足背中間皮神經(jīng)營養(yǎng)血管為多節(jié)段、多源性,與術(shù)式關(guān)系密切在第4跖骨間隙近端淺出的足底弓第3足背穿支位置相對恒定,并分出眾多的細(xì)小血管與足背中間皮神經(jīng)干或旁營養(yǎng)血管鏈的分支密切吻合。結(jié)論可形成以足底弓第3足背穿支蒂足背中間皮神經(jīng)營養(yǎng)血管皮瓣轉(zhuǎn)位修復(fù)前足軟組織缺損。
[Abstract]:Objective to provide anatomic basis for repairing soft tissue defect of forefoot with perforator pedicled medial cutaneous neurovascular flap. Methods Anatomical observation was performed on 30 adult foot specimens infused with red latex into the artery to observe the movement and distribution of the middle cutaneous nerve of 1 foot and the anastomosis between the dorsal perforating branch of the third plantar arch and the nutrient vessels of the middle cutaneous nerve of the dorsalis pedis. In addition, a mimic surgical design was performed on one fresh specimen. Results 1 the medial cutaneous nerve of the dorsalis pedis was mainly the extension of the lateral branch of the superficial peroneal nerve. The neurotrophic vessels of the middle cutaneous nerve of the dorsalis pedis were multisegmental and multisource distributed in the skin of partial dorsal foot and dorsal toe of foot. The position of the third dorsal perforating branch of the foot arch was relatively constant in the proximal space of the fourth metatarsal bone. The small vessels were closely anastomosed with the branches of the trunk of the medial cutaneous nerve of the dorsalis pedis or the branches of the vegetative vascular chain. Conclusion the pedicle of the third foot dorsal perforating branch can be used to repair the soft tissue defect of the forefoot by transposition of the medial cutaneous neurovascular flap pedicled with the third plantar arch.
【作者單位】: 蚌埠醫(yī)學(xué)院?偨虒W(xué)醫(yī)院(南京軍區(qū)福州總醫(yī)院)骨科研究所;福建醫(yī)科大學(xué)附屬第一醫(yī)院骨科;
【基金】:福建省自然科學(xué)基金資助項(xiàng)目(2015J01412) 南京軍區(qū)醫(yī)學(xué)科技創(chuàng)新重大專項(xiàng)(ZX30) 蚌埠醫(yī)學(xué)院研究生科研創(chuàng)新計(jì)劃項(xiàng)目(Byycx1619)
【分類號】:R658;R322.7
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本文編號:2045275
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