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目的研究股内侧肌肌皮穿支解剖学特征,设计游离股内侧肌穿支皮瓣,为临床修复软组织缺损提供一种新的皮瓣。方法取6具自愿捐献的新鲜成人下肢标本,以氧化铅混合红色乳胶灌注,解剖股内侧肌肌皮穿支,并通过血管造影技术观测股内侧肌肌皮穿支的起源、走行、分布情况。根据解剖研究,于2009年6月-2011年8月,临床采用大小为14 cm×6 cm～20 cm×5 cm的股内侧肌穿支皮瓣修复4例足部皮肤软组织缺损,缺损范围8 cm×6 cm～12 cm×8 cm。结果股动脉恒定发出的股内侧肌动脉在内侧肌内下行至髌旁,终末支与旋股外侧动脉终末支吻合形成髌周血管网。沿途发出3～5支粗大肌皮穿支达深筋膜内,并浅出至股内侧肌表面皮肤,构成股内侧血管网。临床应用4例股内侧肌穿支皮瓣均成活,受区创面及供区切口均Ⅰ期愈合;患者均获随访,随访时间6～12个月,皮瓣色泽、质地良好,踝关节背伸、跖屈活动范围正常。结论游离股内侧肌穿支皮瓣切取简便,皮瓣供区隐蔽,质地优良,是理想的皮瓣供区。
Objective To study the anatomical characteristics of the muscular perforation of the medial femoral muscle and to design the perforator flap of the medial side of the free muscle to provide a new flap for the clinical repair of soft tissue defects. Methods Six fresh adult volunteers were randomly divided into three groups. The perfusions of DRM were dissected with red lead mixed with red lead and the origin, course and distribution of MCM were observed by angiography. According to the anatomic study, from June 2009 to August 2011, 4 cases of skin soft tissue defects of the foot were repaired with the medial femoral cutaneous branches of 14 cm × 6 cm ~ 20 cm × 5 cm. The defect range was 8 cm × 6 cm ~ 12 cm × 8 cm. Results The medial femoral artery with constant femoral artery was dilated medially to the patellar side. The terminal branch was anastomosed with the terminal branch of the lateral femoral artery to form the patellofemoral vascular network. Along the way issued 3 to 5 thick musculature perforation to reach deep fascia, and shallow to the medial femoral surface of the skin, constitute the stock network vascular network. All the patients were followed up for 6 to 12 months. The color and texture of the flaps were good, and the ankle dorsiflexion , Plantar flexion range of normal activities. Conclusions The medial lateral muscle flap of free muscle is simple and easy to cut. The flap is concealed by the donor area and has good texture. It is an ideal flap donor area.