摘要
目的探讨胫骨外侧近端骨膜穿支骨皮瓣的应用解剖与临床应用。方法2015年3月至2017年3月．国人新鲜尸体15具（30侧）。动脉内灌注红色乳胶并进行层次解剖，观测胫骨近端外侧骨膜穿支血管（口径≥0．5mm）的起源、分支、分布及其吻合，重点观察胫前动脉近端穿支相关数据。自2015年3月至2017年3月．临床应用胫骨外侧近端骨膜穿支骨皮瓣游离移植修复手足部复合组织缺损16例．损伤皮肤面积3．0cm×0．8cm～6．0cm×5．5cm．骨质缺损大小为1．7cm×1．5cm×1．0cm．5．0cm×1．0cm×1．0cm．应用皮瓣面积3．0cm×0．8cm～6．0cm×5．5cm．骨瓣大小1．6cm×1．0cm×0．8cm～5．0cm×1．0cm×1．0cm。定期进行随访。结果解剖显示穿支直径0．5～1．2mm．蒂长2．5～4．3cm。临床应用16例，有14例获得随访，时间6．24个月，皮瓣色泽正常，质地良好，厚薄适中，两点辨别觉5～8mm，无1例因皮瓣臃肿需要二期修整：骨瓣移植愈合时间2～4个月，无延迟及不愈合情况发生。术后2～4个月拆除内固定物助能正常，负重行走，奔跑跳跃无异常。结论胫骨外侧近端骨膜穿支位置恒定．易于定位．管径符合吻合要求．其骨皮瓣适合修复手足等部位中小面积的骨皮缺损．
Objective To provide anatomical information and clinical application of periosteal perforator boneskin flap of proximal lateral tibia. Methods From March, 2015 to March, 2017, 15 fresh cadavers who underwent injected with imaging technology and dissected with layer by layer. The origins, branches, distribution and anastomosis of periosteal perforator vessels in the proximal lateral tibial were observed. Sixteen patients of composite tissue defect in hands and feet were repaired with the method of free transplantation of this flap from March, 2015 to March, 2017. Injured area was from 3.0 cm × 0.8 cm to 6.0 cm × 5.5 cm. Bony defect size was from 1.7 cm × 1.5 cm × 1.0 cm to 5.0 cm ×1.0 cm × 1.0 cm. The bone-skin flap size ranged respectively from 3.0 cm × 0.8 cm to 6.0 cm× 5.5 cm and 1.6 cm ×1.0 cm × 0.8 cm to 5.0 cm×1.0 cmx 1.0 cm. Postoperative followed-up was done termly. Results The diameter and superficial length of the main perforators respectively were 0.5 to 1.2 mm and from 25 to 4.3 cm. The followed-up time was from 6 to 24 months in 14 cases, with the results of the bone-skin flaps presented favonrable contours and good functions. The healing time of bone flap was 2 to 4 months, The function of shank was normal. Conclusion The periosteal perforator of proximal lateral tibia has favourable appearance, constant vascular pedicle. reliable blood supply and large diameter. The free transplantation of this flap offers a satisfactory alternative for repairing the small and medium-sized area of composite tissue defects of hands and feet.
出处
《中华显微外科杂志》
CSCD
北大核心
2017年第6期564-567,共4页
Chinese Journal of Microsurgery
基金
国家自然科学基金（81570608）
关键词
胫前动脉
骨膜穿支
骨皮瓣
修复
应用解剖
Anterior tibial artery
Periosteal perforator
Bone-skin flap
Repair
Applied anatomy
作者简介
通信作者：魏义涛，Email：13543664469@163．com
