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目的 :为以逆行岛状V型腓骨肌皮瓣修复跟骨及后足大面积软组织缺失提供解剖学资料。方法 :在 5 0侧下肢标本、40块跟骨上对腓骨肌皮瓣的血供、血管蒂旋转点的设定及跟骨内骨小梁的分布情况等进行了观测。结果 :①腓动脉沿途发出 7.6支肌皮支 ,分布到腓骨及其邻近软组织 ,该动脉下端与胫前、胫后动脉有丰富而粗大的吻合 ,完全可提供逆流供血 ;②跟骨内骨小梁的分布在不同的矢状切面上有明显的差异 ,这与其负重时的应力分布有关。结论 :以腓血管为蒂截取的腓骨肌皮瓣经塑形成V型复合瓣 ,可用于后足大面积缺损的再造。临床成功 1例 ,证实术式具有可行性。
OBJECTIVE: To provide anatomic data for retrograde island V-type fibular myocutaneous flap to repair large-area soft tissue defects in the calcaneus and hindfoot. Methods: The blood supply of the peroneal muscle flaps, the setting of the pedicle of the pedicle and the distribution of the trabecular bone in the calcaneus were observed in 50 lower extremity specimens and 40 calcaneus. Results: (1) The peroneal artery sent out 7.6 myocutaneous branches distributed to the fibula and its adjacent soft tissues. The inferior part of the artery had an abundant and coarse anastomosis with the anterior tibial and posterior tibial arteries, which could provide the countercurrent blood supply completely. Beam distribution in different sagittal sections have significant differences, which is related to the stress distribution when the load. CONCLUSION: The fibular myocutaneous flap pedicled on the pedicle of the vessel is shaped into a V-shaped composite flap which can be used to reconstruct the large area defect of the hind foot. One case of clinical success, confirmed the feasibility of surgical procedures.