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目的对展肌上缘动脉弓的形成进行分型,为以展肌上缘动脉弓为蒂逆行足底内侧皮瓣的临床应用提供解剖学基础。方法在81例足动脉铸型标本和2只动脉灌注红色乳胶成人新鲜下肢标本上观察展肌上缘动脉弓的形成、走形与分布。结果根据展肌上缘动脉弓的形成将其分为3型:Ⅰ型.内踝前动脉与跗内侧动脉型:主要由内踝前动脉、跗内侧动脉及其分支形成,占22.9%(19例)。Ⅱ型.足底内侧动脉浅支型:主要由足底内侧动脉浅支及其分支形成,占3.6%(3例)。Ⅲ型.混合型:由足底内侧动脉浅支与内踝前动脉、跗内侧动脉及其分支相互吻合形成。根据吻合形式的不同,又将其分为两个亚型,Ⅲ1型.直接吻合型:内踝前动脉、跗内侧动脉发出后直接与足底内侧动脉浅支及其分支吻合形成,占48.2%(40例);Ⅲ2型.间接吻合型:内踝前动脉、跗内侧动脉发出后与足底内侧动脉浅支及其分支相互吻合成环形,占24.1%(20例)。结论根据展肌上缘动脉弓形成的不同分为内踝前动脉与跗内侧动脉型、足底内侧动脉浅支型和混合型。其中混合型又分为直接吻合型和间接吻合型两种亚型。
OBJECTIVE: To provide anatomical basis for the clinical application of medial flap pedicled with the superior arch margin of the abductor muscle. Methods The formation, shape and distribution of the superior arch margin of the posterior brachial muscle were observed on 81 cases of arteries of the foot and 2 arteries of fresh lower limbs infused with red latex. Results According to the formation of the superior margin of the extensor brachii, it was divided into three types: type I. The anterior medial malleolus and the medial malleolus were mainly formed by the anterior medial malleolus, the medial malleolus and its branches, accounting for 22.9% (19 cases ). Type Ⅱ. Superficial medial plantar artery type: mainly formed by the superficial branch of medial plantar artery and its branches, accounting for 3.6% (3 cases). Type Ⅲ. Mixed type: the plantar medial artery from the superficial branch and the ankle anterior artery, medial 跗 artery and its branches formed by mutual agreement. According to the different forms of anastomosis, it is divided into two subtypes, type Ⅲ 1. Direct anastomosis: the ankle anterior artery and medial pterygoid artery are formed directly and anastomosed with the superficial branch of the medial plantar artery and its branches, accounting for 48.2% 40 cases); Ⅲ type 2. Indirect anastomosis: the anterior branch of the medial malleolus and the medial side of the medial malleolus were anastomosed with the superficial branches of the medial plantar artery and the branches, accounting for 24.1% (20 cases). Conclusions According to the formation of the upper arch margin of the abductor muscle, the medial malleolus artery is divided into the medial malleolus artery, the medial plantar artery, the medial plantar artery, and the mixed type. Which mixed type is divided into direct anastomosis and indirect anastomosis two subtypes.