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目的 :为带腓肠神经营养血管蒂岛状皮瓣的临床应用提供解剖学依据。方法 :在 3 8侧经动脉灌注红色乳胶成人下肢标本上解剖观测腓肠神经及营养血管的起始、走行、分支分布、吻合及外径 ,2侧成人新鲜下肢标本墨汁灌注观察营养血管的墨染范围。结果 :腓肠神经由腓肠内侧皮神经与腓神经交通支汇合而成 ,其汇合点在外踝上 12 .7± 3 .7cm ,腓肠神经沿窝中点至外踝与跟腱中点连线下行 ,外踝上 12 .6± 3 .4cm处穿出深筋膜。其营养血管主要来源于窝中间皮动脉和腓动脉肌间隔穿支 ,上段起始部外径 0 .6± 0 .1mm ,下段距外踝上 6.7± 1.6cm处与腓动脉穿支恒定吻合 ,吻合支外径 0 .6± 0 .1mm ,沿途发出众多筋膜皮支营养小腿后部皮肤。结论 :以腓肠神经及其营养血管为蒂可设计切取顺行或逆行岛状皮瓣。
Objective: To provide anatomical basis for the clinical application of island flap with sural nerve nutrition vessels. Methods: The starting, walking, branching distribution, anastomosis and external diameter of the sural nerve and nutrient vessels were observed on the lower extremity of the adult with the red latex on the 38 sides. range. Results: The sural nerve was formed by the junction of the medial sural nerve of the sural nerve and the peroneal nerve. The confluence point was 12.7 ± 3. 7cm on the lateral malleolus. The sural nerve was connected along the midpoint of the popliteal fossa midpoint to the midpoint of the Achilles tendon Line line, the lateral malleolus 12.6 ± 3.4cm at deep fascia. The nutrient vessels mainly originated from the popliteal median artery and peroneal muscle intermucular perforation, the outer diameter of the upper segment was 0.6 ± 0.1mm, the lower segment was consistent with the perforating branch of the peroneal artery at 6.7 ± 1.6cm from the lateral malleolus, Anastomotic branch diameter 0 .6 ± 0 .1mm, along the way issued numerous fascia skin support leg skin behind the leg. Conclusion: The sural nerve and its nutrient vessels can be designed to cut the anterior or retrograded island flap.