目的解剖分析小腿部腓动脉穿支的穿出规律及各穿支血管之间的联系,为临床设计腓动脉双穿支皮瓣提供形态学基础。方法新鲜小腿标本8例行动脉灌注乳胶-氧化铅,对腓动脉各穿支血管解剖结构主要是血管的形态、走形、分布进行研究分析,筛选适合做双穿支皮瓣的血管蒂。临床上应用7例,均为吻合双血管蒂皮瓣,并逐渐扩大皮瓣切取面积,皮瓣大小:5cm×9cm~8cm×15cm。结果腓动脉直径≥5mm的穿支血管4~5支,其中以第2支穿支外径最粗,外径为(0.94±0.11)mm、血管蒂较长,蒂长为(6.61±1.32)cm、皮瓣血供面积较大适合作为首选穿支蒂再联合其他穿支设计双穿支皮瓣。7例双皮支腓动脉穿支皮瓣均成活,随访3~12个月,穿支皮瓣质地优良,外观及功能恢复较佳。结论设计以第2穿支联合其他穿支的腓动脉双穿支皮瓣,皮瓣轴心线位于穿支点后侧,临床上可切取血供佳、面积较大的腓动脉穿支皮瓣。 Objective To anatomize the perforation regularity of the peroneal perforation of the lower leg and the relationship between the perforating branches and to provide the morphological basis for clinical design of the perforator flap of the peroneal artery. Methods 8 cases of fresh calf were artificially infused with latex - lead oxide. The anatomical structures of the perforator branches of the peroneal artery were mainly the morphology, shape and distribution of blood vessels, and the scaffolds suitable for double perforating branch flap were screened. Seven cases were clinically applied. All of them were anastomosed with double-vessel pedicle flap and gradually expanded the skin flap area. The flap size was 5cm × 9cm ~ 8cm × 15cm. Results There were 4 to 5 perforator blood vessels with diameter of 5 mm or more. Among them, the diameter of the second branch was the coarsest, the outer diameter was (0.94 ± 0.11) mm, the pedicle length was longer and the pedicle length was (6.61 ± 1.32) cm, larger flap blood supply area suitable for use as the preferred wear pedicle and then combined with other perforating branch design double perforating branch flap. Seven cases of percutaneous peroneal perforator flap survival, follow-up of 3 to 12 months, perforator flap texture is good, better appearance and function recovery. Conclusion The design of the second perforating branch combined with the other perforating peroneal double perforating branch flaps with the axial line of the flap located on the posterior side of the perforating branch can cut off the perforator flap of the peroneal artery that has good blood supply and large area.