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目的为设计逆行缝匠肌皮瓣转位修复小腿皮肤缺损提供解剖学基础。方法解剖观测40侧缝匠肌的动脉来源、走行、外径、分布及吻合。取4侧新鲜成尸下肢标本进行动脉造影,观察缝匠肌内动脉吻合。结果营养缝匠肌的动脉为6～7支,呈节段性分布,缝匠肌的上1/5段动脉来源于旋髂浅动脉、旋股外侧动脉或股深动脉,中2/5段动脉来源于股动脉,下2/5段动脉来源于隐动脉。隐动脉起点位于内收肌结节上(10.2±1.0)cm处,外径(1.5±0.2)mm,向下发出3～5个分支入缝匠肌,隐动脉终末支在膝下内侧参与膝关节网。缝匠肌的各节段动脉在肌内分为4～7支沿缝匠肌纵轴走行,相邻动脉的分支在肌内形成链型吻合,吻合处外径0.3mm左右。深筋膜表面有皮动脉和肌皮动脉形成的链式血管吻合网,营养缝匠肌表面的皮肤。结论缝匠肌内动脉链型吻合为逆行缝匠肌皮瓣供血,扩大了该肌皮瓣的切取长度,故以隐动静脉为血管蒂的逆行缝匠肌皮瓣可修复小腿中下段软组织缺损。
Objective To provide an anatomical basis for the design of retrograde sartorius muscle flap transposition and repair of skin defects of calf. Methods Anatomical observation of 40 sartorius muscle sartorius arteries, walking, diameter, distribution and anastomosis. Take 4 fresh adult corpse lower limb specimens for angiography, observe the sartorius intramuscular artery anastomosis. Results The sartorius arteries had 6 ~ 7 arteries in segmental distribution. The 1 / 5th artery of the sartorius muscle originated from the superficial iliac artery, the lateral femoral artery or the femoral artery, Arteries originate from the femoral artery, and the lower 2/5 arteries originate from the saphenous artery. The origin of the saphenous artery is located at the medial adductor muscle (10.2 ± 1.0) cm with an outer diameter of (1.5 ± 0.2) mm. Three to five branches are sutured downward into the sartorius muscle. The terminal branch of the saphenous artery is medially involved in the knee. Joint network. The sartorius muscle segment arteries in the muscle is divided into 4 to 7 along the sartorius muscle longitudinal axis, the adjacent artery branches in the muscle to form a chain anastomosis, the anastomosis diameter of about 0.3mm. Deep fascia surface of the dermal artery and the formation of muscular artery chain vascular anastomosis network, the surface of nutrition sartorius muscle skin. Conclusions Sartorius muscle chain anastomosis is retrograde sartorius muscle flap, which enlarges the cut length of the myocutaneous flap. Therefore, retrograde sartorius muscle flap with vascularized pedicled vein can repair soft tissue defect in the lower leg .