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目的 :为带膝降动脉大收肌腱骨皮瓣修复小腿及跟骨的创伤提供应用解剖学基础。方法 :在70侧成人下肢标本上解剖观测了膝降动脉的起始、分支、分布及大收肌腱的形态特点和血管分布。结果 :①膝降动脉的主干长 1.2± 0 .5cm ,起点外径为 2 .6± 0 .6mm ,主要分支有股内侧肌支、关节支、隐支。②关节支的主干长 6.6± 1.2cm ;起点外径为 1.9± 0 .5 ,分支营养大收肌腱和股骨内侧髁骨质骨膜 ,并参与吻合形成膝关节动脉网。③隐动脉长 10 .9± 3 .3cm ,起点外径 1.8± 0 .6mm。分支营养缝匠肌下部、膝内侧上部皮肤 ,并参与吻合形成膝关节动脉网。④胫后动脉、腓动脉在内踝上方 11cm处的直径分别是 2 .5± 0 .6mm和 2 .0± 0 .4mm。⑤大收肌肌腱部长 6.8± 1.2cm ,宽 9.6± 2 .0mm ,厚 2 .2± 0 .6mm。结论 :带膝降动脉大收肌腱骨瓣、皮瓣血供丰富 ,供区形态可塑性大 ,可作为修复跟腱、跟骨及皮肤缺损的供体。
OBJECTIVE: To provide an anatomical basis for repairing the trauma of calf and calcaneus with the adductor lesser great adductor tendon bone flap. Methods: The onset, branching and distribution of the knee descending arteries and the morphological features and vascular distribution of the greater tendon were observed anatomically on 70 adult lower extremities. Results: ① The main length of the knee descending artery was 1.2 ± 0.5cm, the starting point diameter was 2.6 ± 0.6mm, and the main branch had the medial muscular branch, joint branch and hidden branch. The main branch of the branch of the articular length 6.6 ± 1.2cm; starting point of the outer diameter of 1.9 ± 0.5, branch of the adductor tendon and femoral condylar medullary periosteum, and involved in the formation of the arteries of the knee artery. ③ hidden artery length 10 .9 ± 3 .3 cm, the starting point diameter of 1.8 ± 0 .6 mm. Branch nutrition sartorius lower muscle, knee medial upper skin, and participate in the formation of knee arteries. The diameter of the posterior tibial artery and the peroneal artery at 11 cm above the medial malleolus were respectively 2.5 ± 0.6 mm and 2.0 ± 0.4 mm. ⑤ Adductor muscle tendon length 6.8 ± 1.2cm, width 9.6 ± 2.0mm, thickness 2.2 ± 0.6mm. CONCLUSION: The pedicled great adductor tendon bone flap with ample blood supply to the donor area has great plasticity in the donor area. It can be used as a donor for repair of Achilles tendon, calcaneus and skin defect.