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目的 :为吻合血管的大收肌腱复合组织瓣移植修复跟腱缺损新术式提供解剖学依据。方法 :在 40侧经动脉灌注红色乳胶成人尸体下肢标本上 ,对膝降动脉的起始、走行、分支和分布 ,以及大收肌腱的形态、血供等解剖观察。结果 :膝降动脉 95 %起于股动脉 ,起始处距收肌结节 7.8± 0 .8cm ,膝降动脉90 %发出隐支、股内侧肌支和关节支 ,膝降动脉和关节支起始外径分别为 :1.9± 0 .4mm和 1.4± 0 .4mm ,关节支伴大收肌腱下行 ,分支供养大收肌腱及股骨内侧髁。结论 :以膝降血管为蒂可形成大收肌腱骨皮复合组织瓣 ,吻合血管移植可修复不同类型的跟腱缺损 ,术式简便易行 ,供区损伤小。
OBJECTIVE: To provide anatomical basis for a new surgical technique of repairing Achilles tendon defect by adduction of large adductor tendon composite tissue flap. Methods: The 40 adult arteries were infused with the red latex into the lower limbs of adult cadaver to study the anatomy of the knee artery, its origin, course, branching and distribution, morphology and blood supply of the adductor tendon. Results: Ninety-five percent of the knee-descending artery originated from the femoral artery. From the start, it was 7.8 ± 0.8cm away from the musculocutaneous tubercle and 90% of the knee-descending artery. The medial muscular branches and articular branches, knee descending arteries and articular branches The initial diameter were: 1.9 ± 0. 4mm and 1.4 ± 0. 4mm, adduction of the great adductor tendon tendon branch, the branch of adductor tendon and medial femoral condyle. CONCLUSIONS: The adductor lessening blood vessels can be used to form composite tissue flap of the great adductor muscle tendon. Different types of Achilles tendon defects can be repaired by vascular anastomosis. The surgical procedure is simple and easy, and the donor area is less damaged.