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目的探讨(足母)展肌上缘动脉弓逆行岛状皮瓣的血供来源,为其修复前足底皮肤缺损的临床应用提供解剖学基础。方法新鲜和固定下肢标本各12例,解剖观测(足母)展肌上缘动脉弓形成及伴行神经、静脉的管径、走形、分布情况,据此设计以(足母)展肌动脉弓为蒂逆行足底内侧岛状皮瓣修复前足底皮肤缺损并重建远端血运术式。结果内踝前动脉、跗内侧动脉及其发出分支的前后支与(?)趾底内侧动脉浅支、足底内侧动脉浅支吻合形成的(足母)展肌上缘动脉弓,成为跗内侧、足内侧与足底内侧动脉网的轴心线。内踝前动脉外径(1.02±0.03)mm,伴随静脉外径(1.01±0.03)mm,多为1条,占91.67%,偶见两条,占8.33%;跗内侧动脉外径(0.73±0.04)mm,伴随静脉外径(0.81±0.04)mm,多为1条,占91.67%,偶见两条,占8.33%;足底内侧动脉浅支外径(0.56±0.02)mm,伴随静脉外径(0.57±0.01)mm,多为1条,占91.67%,偶见两条,占8.33%;(足母)展肌上缘动脉弓远端外径(0.53±0.14)mm,伴随静脉外径(0.61±0.02)mm,多为1条,占91.67%,偶见两条,占8.33%。结论 (足母)展肌上缘动脉弓逆行岛状皮瓣可设计三种术式修复前足底皮肤缺损,以内踝前动脉与跗内侧动脉、以足底内侧动脉浅支、以三条动脉共同为主要血供动脉;可设计以第一跖骨颈、第一跖趾关节以远为转移点的两种皮瓣,使该皮瓣血管蒂长、可切取面积大,增加了临床应用的灵活性。
Objective To investigate the source of blood supply of retrograde island flap on the superior margin of the muscular abductor muscle and to provide anatomical basis for its clinical application in repairing the skin defect of the plantar. Methods Fresh and fixed lower extremity specimens were obtained from 12 patients. The anatomical observation was made on the formation of the arch of the superior margin of the muscle of the foot and the diameter, shape and distribution of the accompanying nerves and veins. The arch serves as a retrograde plantar medial island flap to repair the anterior plantar skin defect and reconstruct the distal blood vessel operation. Results The anterior artery of the medial malleolus, the medial malleolus, the anterior superior and posterior branches of the medial branch of the medial femoral artery, Axial line of the medial foot and medial plantar artery. The diameter of the ankle artery was (1.02 ± 0.03) mm, with the outer diameter of the vein (1.01 ± 0.03) mm, the number was 1, accounting for 91.67% ) mm, with the outer diameter of vein (0.81 ± 0.04) mm, mostly one, accounting for 91.67%, occasionally two, accounting for 8.33%; the diameter of the superficial branch of medial plantar artery (0.56 ± 0.02) mm, (0.57 ± 0.01) mm, mostly one, accounting for 91.67%, and occasionally two, accounting for 8.33%. The distal diameter of the upper margin of the superior margin of the foot of the foot (0.53 ± 0.14) mm, with the exception of the vein Diameter (0.61 ± 0.02) mm, mostly 1, accounting for 91.67%, occasionally two, accounting for 8.33%. Conclusions The retrograde island flaps of the upper margin of the muscularis propriocephalus muscle can be designed to repair the plantar skin defect before the repair. The medial malleolus artery and the medial pterygoid artery, the superficial branch of the medial plantar artery, and the three arteries together The main blood supply artery; can be designed to the first metatarsal neck, the first metatarsophalangeal joint far point for the transfer of two kinds of flaps, so that pedicle flap length, can be cut large area, increasing the flexibility of clinical applications.