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目的为逆行腓骨肌皮瓣的设计与临床应用提供解剖学依据。方法新鲜下肢标本20侧,动脉灌注红色乳胶,解剖观测腓动脉、腓骨长肌、腓骨短肌及其表面皮肤与营养血管的的起始、走行、分支、分布的情况;新鲜标本2具,动脉灌注乳胶、氧化铅混悬液,CT扫描后三维重建小腿与足部血管。结果腓动脉起始外径(3.7±0.7)mm,多条分支供给比目鱼肌、长屈肌、腓骨长、短肌及表面皮肤。腓动脉穿支的血管蒂可游离长度为(3.5±1.3)cm。腓动脉终末穿支在胫腓骨骨间膜中穿出,外径(1.2±0.4)mm,分为升支和降支。腓骨短肌肌腹的上部有一支较粗的腓浅动脉发自胫前动脉,向前穿骨间膜行于腓骨长肌与小腿前群肌之间,管径(1.8±0.5)mm,行向下营养腓骨短肌、腓浅神经和小腿前外侧部皮肤。结论以腓动脉中、下部穿支或终末穿支与其它血管的吻合部为蒂,可以设计切取逆行腓骨长、短肌肌皮瓣,修复小腿下部及足背部软组织缺损。
Objective To provide an anatomical basis for the design and clinical application of retrograde fibular myocutaneous flap. [Methods] 20 cases of fresh lower extremity specimens were infused with red latex through arterial blood to study the origin, course, branching and distribution of peroneal artery, peroneus longus muscle, peroneus brevis muscle and its surface skin and nutrient vessels. Fresh specimens of 2 arteries Perfusion of latex, lead oxide suspension, three-dimensional reconstruction of the lower leg and foot vessels after CT scan. Results The diameter of the common peroneal artery was (3.7 ± 0.7) mm. Multiple branches were supplied to the soleus, long flexor, fibula, short and superficial skin. Perforator pedicle perforator pedicle free length of (3.5 ± 1.3) cm. Perforator of the peroneal artery perforating branches in the tibiofibular interosseous membrane, diameter (1.2 ± 0.4) mm, divided into ascending and descending branch. The upper part of the fibula of the short musculature has a thick, superficial peroneal artery originating from the anterior tibial artery and the anterior interosseous membrane extending between the peroneus longus muscle and the anterior posterior fossa of the calf with a diameter of (1.8 ± 0.5) mm Down nutrition peroneus brevis muscle, peroneal nerve and calf anterolateral skin. Conclusions With the anastomosis of middle and inferior perforating branches or terminal perforating branches of the peroneal artery and other blood vessels as the pedicle, the long and short musculocutaneous flaps of the retrusive fibula can be designed to repair the soft tissue defects of the lower part of the lower leg and the dorsal foot.