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缝匠肌肌瓣手术构建的解剖学贡献。

Anatomical contribution to the surgical construction of the sartorius muscle flap.

作者信息

Tanaka Clarice, Ide Maiza Ritomy, Junior Aldo Junqueira Rodrigues

机构信息

Department of Physiotherapy, Speech-Language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, 4 andar, Bloco 3, 4521, São Paulo , Brazil.

出版信息

Surg Radiol Anat. 2006 Jun;28(3):277-83. doi: 10.1007/s00276-006-0088-x. Epub 2006 Mar 24.

DOI:10.1007/s00276-006-0088-x
PMID:16557344
Abstract

The sartorius muscle (SM) is frequently used as a surgical flap. This study intends to describe sartorius nerve and artery distribution in adult men. Fifty-three specimens obtained from fresh cadavers were prepared as described: 32 specimens were injected with a red-colored gelatin solution through the femoral artery so that intra-muscular arteries and nerves were dissected; six specimens were injected with barium sulfate solution through the femoral artery for radiography; seven specimens were injected with a Chinese ink solution, also through the femoral artery, for diaphanization; seven specimens were injected with a solution of vinyl acetate, through the femoral artery, to obtain an arterial cast and one specimen was cut and colored by Masson's Trichrome. Sartorius branching patterns of the nerve and artery were schematized. The following measurements were taken for each dissected muscle: total length, arterial pedicle length and distance between each arterial pedicle to the proximal muscle extremity. Five to nine arterial pedicles were found in the sample. In their trajectories, these arteries may give rise to many branches to form a dense and elongated net of anastomoses. Intra- and inter-pedicular anastomoses were observed in the inner part of the muscle. The nerve supply originated from one or two branches, which enter the muscle together with the first or second arterial pedicle. The nerve branches were divided into two or three territorial branches, and then into four or five segmental branches, running longitudinally inside the muscle. The muscles showed an average length of 44.81 cm. SM is a segmented structure and it can be divided into as many as five arterial and nervous segments. In the proximal and middle parts, the muscle has better arterial supply. The segments can be filled by adjacent pedicles, due to an elongated net of anastomoses, which allow a longer arc of rotation in the construction of pedicled flaps.

摘要

缝匠肌(SM)常被用作手术皮瓣。本研究旨在描述成年男性缝匠肌神经和动脉的分布情况。按照以下方法制备了从新鲜尸体获取的53个标本:32个标本通过股动脉注入红色明胶溶液,以便解剖肌内动脉和神经;6个标本通过股动脉注入硫酸钡溶液进行放射摄影;7个标本同样通过股动脉注入中国墨汁溶液进行透照;7个标本通过股动脉注入醋酸乙烯溶液以获得动脉铸型,1个标本经Masson三色染色法切割染色。绘制了缝匠肌神经和动脉的分支模式图。对每块解剖的肌肉进行了以下测量:总长度、动脉蒂长度以及每个动脉蒂至肌肉近端的距离。样本中发现5至9个动脉蒂。在其走行过程中,这些动脉可发出许多分支,形成密集且细长的吻合网。在肌肉内部观察到了蒂内和蒂间吻合。神经供应源自一或两个分支,它们与第一或第二动脉蒂一起进入肌肉。神经分支分为两或三个区域分支,然后再分为四或五个节段分支,在肌肉内纵向走行。这些肌肉的平均长度为44.81厘米。缝匠肌是一种分段结构,可分为多达五个动脉和神经段。在近端和中部,肌肉的血液供应较好。由于存在细长的吻合网,各段可由相邻的蒂供血,这使得在构建带蒂皮瓣时能够有更长的旋转弧。

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Management of early groin vascular bypass graft infections with sartorius and rectus femoris flaps.应用缝匠肌和股直肌皮瓣治疗早期腹股沟血管旁路移植感染
Ann Plast Surg. 2004 Jan;52(1):49-53. doi: 10.1097/01.sap.0000099960.68038.53.
2
[Disarticulation of the knee joint].[膝关节离断术]
Acta Chir Orthop Traumatol Cech. 2003;70(2):95-9.
3
Coverage of difficult wounds around the knee joint with prefabricated, distally based sartorius muscle flaps.采用预制的、以远端为蒂的缝匠肌肌瓣覆盖膝关节周围的难愈创面。
Ann Plast Surg. 2003 May;50(5):484-90. doi: 10.1097/01.SAP.0000044146.45427.1B.
4
Primary skin closure of large groin defects after inguinal lymphadenectomy for penile cancer using an abdominal cutaneous advancement flap.使用腹部皮肤推进皮瓣对阴茎癌腹股沟淋巴结清扫术后的大型腹股沟缺损进行一期皮肤缝合。
J Urol. 2003 Jan;169(1):118-20. doi: 10.1016/S0022-5347(05)64049-9.
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[Application of sartorius muscle in the quadricepsplasty].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1999 Nov;13(6):355-8.
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Superiorly based rectus abdominis wraparound flap for axillofemoral graft sepsis.
Ann Plast Surg. 2001 Aug;47(2):191-3. doi: 10.1097/00000637-200108000-00015.
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Application of a sartorius muscle flap during abdominal wall reconstruction.
Ann Plast Surg. 1999 Jun;42(6):703-5. doi: 10.1097/00000637-199906000-00024.
8
The sartorius muscle: anatomic considerations for reconstructive surgeons.缝匠肌:重建外科医生的解剖学考量
Surg Radiol Anat. 1998;20(5):307-10. doi: 10.1007/BF01630610.
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J Endourol. 1998 Apr;12(2):187-91. doi: 10.1089/end.1998.12.187.
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Free groin flap for reconstruction of the tongue and oral floor.游离腹股沟皮瓣用于舌和口底的重建。
J Reconstr Microsurg. 1998 Jan;14(1):49-55. doi: 10.1055/s-2007-1006901.