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目的探讨膝降动脉穿支的解剖学特征,为临床膝周软组织缺损的修复提供一种新的术式。方法在40侧动脉内灌注红色乳胶成人下肢标本上,以股骨内侧髁下缘、收肌结节为观测标志点,手术放大镜下重点解剖观测:①膝降动脉穿支的起源、分支与分布;②穿支与周围血管间吻合关系。另1侧新鲜标本进行摹拟手术设计。结果膝降动脉穿支于股骨内侧髁下缘上约4cm,在股内侧肌、大收肌腱与股骨内侧髁所围成的三角形凹陷内穿过深筋膜至皮下,并分出众多的细小血管与邻近的髌骨周围血管网、缝匠肌前缘及后缘的穿血管、股内侧皮神经的神经旁和神经干血管链的分支密切吻合,在膝关节内侧上部形成顺沿缝匠肌和股内侧皮神经纵轴的血管丛。结论以膝降动脉穿支为蒂,可形成轴型皮瓣或跨区域供血皮瓣转位修复膝部软组织缺损。
Objective To investigate the anatomic features of percutaneous branches of knee-descending artery and to provide a new surgical method for the repair of clinical knee soft-tissue defects. Methods 40 adult arteries were infused with red latex into the adult lower extremities. The lower edge of the medial condyle of the femur and the muscular nodules were observed. The anatomy was observed under the magnifying glass under the magnifying lens. The origin, branch and distribution of percutaneous branches of the knee descending artery were observed. ② perforation and peripheral vascular relationship between the anastomosis. The other side of the fresh specimens were simulated surgical design. Results The knee of the descending artery descending the medial femoral condyle on the lower edge of about 4cm in the medial femoris tendon and the medial femoral medial condyle formed triangular depression through the deep fascia to the subcutaneous and divided into many small blood vessels With the adjacent patella vascular network around the front and trailing edge of the sartorius through the blood vessels, the nerve fibers inside the medial cutaneous nerve and the branch of the neural stem closely matching the formation of the upper medial knee along the sartorius muscle and stock Medial cutaneous nerve longitudinal axis of vascular plexus. Conclusion With pedicle descending perforator pedicle pedicle, pedicle axial flap or trans-regional skin flap transposition can be used to repair knee soft tissue defect.