目的 揭示踝及足背皮神经的整体分布模式，为皮瓣移植感觉重建提供形态学指导。 方法 成年尸体24具，紧贴肌表面摘取含皮下脂肪的踝及足背皮肤，用改良的Sihler’s染色法显示并观察皮神经整体分布模式。 结果 在Sihler’s染色的标本中，肉眼可见隐神经支配踝前区（40.01±7.6）%、踝后区（30±6.7）%、以及部分足背内侧缘。腓浅神经支配踝前区（60.03±6.8）%，其足背内侧皮神经支配足背内侧区、第1、2趾背及第3趾背内侧半；95.83%的足背中间皮神经分布到第3趾背外侧半、第4、5趾背。腓肠神经支配踝后区（70±5.3）%，其足背外侧皮神经支配足背外侧缘皮肤。腓深神经分布到第1、2趾背相对面。初级神经支密度以踝前区最高，次级及以下神经支密度和总的神经支密度均以足背内侧区最高。 结论 在踝或足背的皮瓣移植中，建议把踝前区或足背内侧区设计为利于感觉重建的首选供区或感觉需求较高的受区。
Abstract
To reveal the overview of distribution pattern of the ankle and dorsal foot cutaneous nerves, and provide morphological guidance for sensory reconstruction in skin flap transplantation. Methods The skin of ankle and dorsal foot with subcutaneous fat was removed from 24 adult cadavers, and the distribution pattern of cutaneous nerve was displayed by the modified Sihler's staining method. Results In the specimen stained with Sihler's staining, the distribution pattern of the cutaneous nerve branches can be seen by naked eyes. The saphenous nerve innervated (40.01±7.6) % of the anterior ankle, (30±6.7) % of the posterior ankle, and part of the medial border of the dorsal foot. The superficial peroneal nerve innervated the (60.03±6.8) % of anterior ankle. The medial dorsal cutaneous nerve innervated the medial dorsal foot, the dorsum of the first and second toe, and the medial half of dorsum of the third toe. 95.83 % of the intermediate dorsal cutaneous nerve innervated the lateral half of dorsum of the third toe, and the dorsum of the fourth and the fifth toe. The sural nerve innervated (70±5.3) % of the posterior ankle, and the dorsolateral cutaneous nerve innervated the dorsolateral border of the foot. The deep peroneal nerve distributed to the opposite side of the first and second toes. The density of the primary nerve branches was the highest in the anterior ankle, and the density of the secondary and subsequent nerve branches and the total nerve branches were the highest in the dorsomedial region of the foot. Conclusions In the flap transplantation of ankle or dorsal foot, it is suggested that the anterior ankle region or the medial dorsal foot region should be designed as the preferred donor site for sensory reconstruction or the recipient site with higher sensory needs.
关键词
踝 /
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足背 /
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皮神经 /
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分布模式 /
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感觉重建
Key words
Ankle /
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Dorsal foot /
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Cutaneous nerve /
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Distribution pattern /
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Sensory reconstruction
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基金
国家自然科学基金（31660294，31540031）
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