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目的探讨小腿后外侧穿支皮支链形成的具体区域,为临床切取小腿后外侧穿支皮支链皮瓣提供解剖学基础。方法新鲜成人尸体下肢标本15侧,(女性2侧,男性13侧),皮肤无外伤及手术史。13侧下肢经股动脉行红色乳胶灌注,手术显微镜下进行精细解剖,充分显示各穿支间的链状吻合,并于穿深筋膜处测量各穿支的外径。2侧下肢制做血管铸型标本,观察皮支链的构筑。结果小腿后外侧穿支数为67支,每侧(5.15±1.86)支,穿深筋膜处的直径为(0.92±0.25)mm;腓骨长度为(34.78±17.78)cm,参与构成小腿后外侧皮支链的穿支数为34支,每侧为(3.31±1.65)支,直径为(0.99±0.23)mm,占所在区域穿支的(28.33±17.79)%~(64.04±19.48)%。结论根据小腿后外侧穿支皮支链分布规律和形式切取皮瓣,不但可适当扩大皮瓣的切取面积,也使皮瓣的血供更加安全。
Objective To study the specific area formed after the posterolateral leg of the calf through the branching branches and provide the anatomic basis for the perforation of the branching branch flaps after the calf extraction. Methods Fifteen sides of the lower extremities of fresh adult cadaver (female 2, male 13) without skin injury and operation history. Thirteen lateral limbs were perfused with red latex through the femoral artery. Fine anatomy was performed under the operation microscope. The chain anastomosis between the perforators was fully demonstrated and the outer diameter of each perforator was measured at the deep fascia. 2 sides of the lower limbs to make vascular cast specimens, observe the construction of the skin branch. Results The posterior posterolateral commissure of the calf was 67 branches (5.15 ± 1.86) on each side. The diameter of the deep fascia reached (0.92 ± 0.25) mm and the length of the fibula was (34.78 ± 17.78) cm. The branching branches of the dermis were 34 branches (3.31 ± 1.65) on each side and the diameter was (0.99 ± 0.23) mm, accounting for (28.33 ± 17.79)% ~ (64.04 ± 19.48)% of the branches in the area. Conclusion According to the rules of the distribution of branching branching branches on the posterolateral side of the calf, the skin flap can not only expand the area of the flap but also make the blood supply of the flap safer.