穿支蒂足背中间皮神经营养血管皮瓣的解剖基础

doi:10.13418/j.issn.1001-165x.2016.06.001

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (6): 601-604.doi: 10.13418/j.issn.1001-165x.2016.06.001

• 应用解剖 • 下一篇

穿支蒂足背中间皮神经营养血管皮瓣的解剖基础

黄磊¹，　胡德庆²，　王田佺¹，　钮朋¹，　洪旭¹，　戚瑞林¹，　郑和平¹

1. 蚌埠医学院福总教学医院（南京军区福州总医院）骨科研究所，福州 350025；
2. 福建医科大学附属第一医院骨科，福州 350005

收稿日期:2016-08-20 出版日期:2016-11-25 发布日期:2016-12-20
通讯作者: 胡德庆，Tel:(0591)87981996，E-mail：hudeqing1987@126.com
作者简介:黄磊（1991-），安徽六安人，男，在读研究生，主要从事显微外科研究，Tel:(0591)24937085
基金资助:
福建省自然科学基金资助项目（2015J01412）；南京军区医学科技创新重大专项（ZX30）；蚌埠医学院研究生科研创新计划项目（Byycx1619）

Anatomical studies of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap

HUANG Lei¹, HU De-qing², WANG Tian-quan¹, NIU Peng¹, HONG Xu¹, QI Rui-lin¹, ZHENG He-ping¹

1. Bengbu Medical College, Affiliated Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou 350025,China；2. Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University，Fuzhou 350005，China

Received:2016-08-20 Online:2016-11-25 Published:2016-12-20

摘要/Abstract

摘要：

目的　为穿支蒂足背中间皮神经营养血管皮瓣修复前足软组织缺损提供解剖基础。方法　在30侧动脉内灌注红色乳胶的成人足标本上解剖观测：①足背中间皮神经的走行与分布；②足底弓第3足背穿支及其与足背中间皮神经营养血管间吻合关系。另在1侧新鲜标本上进行摹拟手术设计。结果　①足背中间皮神经主要为腓浅神经外侧支的延续，经十字韧带表面，径直前行至第4跖骨间隙近端附近分为第3、4跖背支，分布于部分足背和趾背皮肤；②足背中间皮神经营养血管为多节段、多源性，与术式关系密切在第4跖骨间隙近端浅出的足底弓第3足背穿支位置相对恒定, 并分出众多的细小血管与足背中间皮神经干或旁营养血管链的分支密切吻合。结论　可形成以足底弓第3足背穿支蒂足背中间皮神经营养血管皮瓣转位修复前足软组织缺损。

关键词: 足底弓第3足背穿支, 足背中间皮神经, 皮神经营养血管皮瓣

Abstract:

Objective　To provide anatomical basis of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap for repair of soft tissue defects of the forefoot.　Methods　The following contents were investigated in 30 adult feet specimens perfused with red latex. ①The course and distribution of the intermediate dorsal cutaneous nerve. ②The 3rd dorsal perforator of the plantar arch and its anastomosis with the intermediate dorsal cutaneous neural nutrient vessels. Simulated operation was performed on another fresh specimen.　Results　①The intermediate dorsal cutaneous nerve mainly arose from the lateral branch of the superficial peroneal nerve. Crossing the surface of the cruciate ligament, it proceeded forward to the proximal part of the 4th metatarsal gap and then divided into the 3rd and 4th dorsal metatarsal branches, which were distributed in part of dorsal pedal and digital skin. ②The intermediate dorsal cutaneous neural nutrient vessels was multiple in segments and sources, which was closely related to operation type. The 3rd dorsal perforator of plantar arch had a relatively constant position located at the proximal part of the 4th intermetatarsal space. It gave out numerous tiny vessels which anastomosed closely with branches of intermediate dorsal cutaneous neural or paraneural nutrient vessel chain.　 Conclusion　The intermediate dorsal pedal neurocutaneous vascular flap based on the 3rd dorsal perforator of plantar arch could be transferred to repair the soft tissue defects of forefoot.

Key words: The 3rd dorsal perforator of plantar arch, Intermediate dorsal cutaneous nerve, Neurocutaneous vascular flap

黄磊,胡德庆,王田佺,钮朋,洪旭,戚瑞林,郑和平. 穿支蒂足背中间皮神经营养血管皮瓣的解剖基础[J]. 中国临床解剖学杂志, 2016, 34(6): 601-604.

HUANG Lei, HU De-qing, WANG Tian-quan, NIU Peng, HONG Xu, QI Rui-lin, ZHENG He-ping. Anatomical studies of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(6): 601-604.

参考文献

[1] Li L, Song D, Zheng H, et a1. Anatomical basis of the reverse lateral plantar artery perforator flap design[J]. Surg Radiol Anat, 2015, 37(8):983-988.
[2] Song D, Yang X, Wu Z, et a1. Anatomic basis and clinical application of the distally based medialis pedis flaps[J]. Surg Radiol Anat, 2016, 38(2): 213-221
[3] 林涧, 郑和平, 林加福, 等. 第1跖底动脉穿支皮瓣修复母趾软组织缺损[J]. 中华创伤杂志, 2015, 31(9):833-835.
[4] 林涧，郑和平，谢志平. 足底外侧动脉第5跖骨穿支皮瓣解剖与临床应用[J]. 实用手外科杂志, 2015，29（2）：136-138.
[5] 吴农欣, 徐永清, 覃励明, 等. 足背中间皮神经营养血管皮瓣的应用解剖学[J]. 中国临床解剖学杂志, 2006, 24(2)：142-144.
[6] 王鹏, 赵丽, 刘小伟, 等. 逆行足背中间皮神经营养血管皮瓣修复足前端皮肤缺损[J]. 中华整形外科杂志, 2007, 25(4):299-300.
[7] 黄磊, 胡德庆, 郑和平, 等. 足底弓足背穿支皮瓣的解剖学基础[J]. 中华显微外科杂志, 2016, 39(4):51-54.
[8] 张发惠, 郑和平, 宋一平, 等. 腓肠神经—小隐静脉营养血管远端蒂复合瓣的解剖学研究[J]. 中国临床解剖学杂志, 2005, 23(4):357-360.
[9] 张发惠, 郑和平, 宋一平, 等. 内踝区动脉网的显微解剖与隐神经营养血管远端蒂皮瓣的设计[J]. 中国临床解剖学杂志, 2005, 23(2):122-125.
[10]柴益民, 林崇正, 邱勋永, 等. 带皮穿支血管的皮神经营养血管皮瓣的临床应用[J]. 中华整形外科杂志, 2006, 22(1):34-37.
[11]Wu Z, Song D, Lin J, et a1. Anatomic basis of the distally based venocutaneous flap on the medial plantar artery of the hallux with medial plantar vein and nutrient vessels:a cadaveric dissection[J]. Surg Radiol Anat, 2015, 37(8):975-981.
[12]Wang T, Lin J, Song D, et a1. Anatomical basis and design of the distally based lateral dorsal cutaneous neuro-lateral plantar venofasciocutaneous flap pedicled with the lateral plantar artery perforator of the fifth metatarsal bone:a cadaveric dissection[J]. Surg Radiol Anat, 2016，13. [Epub ahead of print]

穿支蒂足背中间皮神经营养血管皮瓣的解剖基础

Anatomical studies of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap

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