带血管蒂腓骨移植应用解剖及并发症探析.docVIP

带血管蒂腓骨移植应用解剖及并发症探析 　 作者：程雄飞，何精选，戴冀斌 【关键词】 带血管蒂腓骨移植；并发症；解剖学 　　[摘 要] 目的 观察腓骨周围重要的血管及其分支的毗邻关系，为临床腓骨移植后出现的并发症提供解剖学依据，并说明腓骨移植手术应注意的问题。方法 采用8例完整的成人下肢标本（其中男6侧，女2侧），对腓骨上、中、下三部分的骨膜营养动脉、滋养动脉及其周围重要动脉分别进行解剖观测。结果 在腓骨上段，从动脉发出一支向腓骨头走行的分支，在腓骨头分出三支动脉，其中一支向下（直径0161 cm）移行为腓骨上段骨膜营养动脉，另一支水平环绕，第三支（平均直径0155 cm）向上平均走行175 cm，直接进入膝关节。在中段除主要的一支腓骨滋养动脉（直径0210 cm）外，其余的细小的腓骨滋养动脉呈节段性进入腓骨，并且一般有腓动脉发出的腓骨膜营养动脉（主干直径为0195 cm），距腓骨头905 cm向下分布中段大部分骨膜。在下段，上部有从腓动脉分出的2～3支弓状动脉（直径0075 cm），绕过腓骨后，继续走行在肌肉之中，在下部距外踝450 cm处有腓动脉穿出后下降。结论 临床上腓骨移植后出现的并发症与各段分布的动脉有密切的关系，保护好这些重要的血管有助于减少并发症的发生。 [关键词] 带血管蒂腓骨移植；并发症；解剖学 A study on the applied anatomy and complication of fibula transplantation with vascular Abstract: Objective To provide anatomical data to explain the clinical complications produced after vasculatized fibula grafts and put forth some suggestions to avoid those complications Methods The whole length of fibula was divided into three portions The nutrient artery, the nourish artery of the fibular periosteum around the fibular were dissected to measure and observe on the lower extremities of 8 cases (male 6 and female 2) which are preserved integrity Results On superior segment of the fibular, one branch from the popliteal artery moving towards the capitulum branched out three arteries One of them run downwards (diameter of 0161 cm) and turned to nourish artery of the fibular periosteum The second branch hooked the fibula horizontally and run backwards The third (diameter of 0155 cm) went upwards with the length of 175 cm averagely, then entered the knee joint directly In the middle segment, tiny nutrient arteries of fibula entered the fibula regularly besides the main nutrient artery (diameter of 0210 cm) of fibula Generally, there is an artery to fibular periosteum (diameter of 0195 cm) came from the fibular artery In the lower segment, there are 2-3 arcuate arteries originated from the fibula artery (diameter of 0075 cm) to supply the muscles located lateral to the fibula Conclusion Taking place of complicatio