Madrid, Spain From Plastic Surgery and Reconstructive Microsurgery, Hospital Quirón, and the Department of Musculoskeletal Radiology, La Paz University Hospital, IdiPAZ and Ciber-BBN.
Plast Reconstr Surg. 2013 Feb;131(2):310-322. doi: 10.1097/PRS.0b013e318278d55f.
There are few references to the reconstructive possibilities of the ascending branch of the lateral circumflex femoral artery other than the tensor fasciae latae muscle flap and the so-called muscle pedicle bone grafting technique.
An anatomical study was performed to evaluate the ascending branch of the lateral circumflex femoral artery and its contribution, through direct branches, to the iliac crest and skin.
In nine of 20 dissections, a small branch of the ascending branch of the lateral circumflex femoral artery was found to reach the iliac crest in the space defined by the rectus femoris, gluteal muscles, and tensor fasciae latae. After emergence of the tensor fasciae latae pedicle, the ascending branch coursed through an anatomical triangular space before entering the trochanteric skin as a direct terminal branch and running for a considerable distance in a posteroinferior direction in the subcutaneous fat. This pretrochanteric triangle was defined by the tensor fasciae latae, the trochanteric insertions of the vastus lateralis and gluteus medius muscles, and the greater trochanter.
The superolateral skin of the thigh can be transferred based on terminal branches of the ascending branch of the lateral circumflex femoral artery. Although inconstant, a small branch of the ascending branch reaches the iliac crest and might support vascularized bone transfer, although more studies are needed to define its role in composite tissue transplantation. This ascending branch might be a good alternative in pedicle or microvascular skin/fat transfer, breast reconstruction, tendocutaneous reconstructions, or composite tissue transplantation.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.
除了阔筋膜张肌肌皮瓣和所谓的肌蒂骨移植技术外，关于旋股外侧动脉升支的重建可能性，仅有少数文献提及。
进行了一项解剖学研究，以评估旋股外侧动脉升支及其通过直接分支向髂嵴和皮肤的贡献。
在 20 次解剖中有 9 次发现旋股外侧动脉升支的一个小分支在股直肌、臀肌和阔筋膜张肌之间的空间到达髂嵴。阔筋膜张肌蒂穿出后，升支在进入转子部皮肤的直接终末支之前，在解剖三角区内走行，在皮下脂肪中向后下方向走行相当长的距离。这个转子前三角由阔筋膜张肌、股外侧肌和臀中肌的转子部附着点和大转子界定。
可以根据旋股外侧动脉升支的终末支转移大腿外侧皮肤。尽管分支不恒定，但升支的一个小分支可以到达髂嵴，并可能支持带血管的骨转移，尽管还需要更多的研究来确定其在复合组织移植中的作用。对于皮瓣或微血管皮/脂肪转移、乳房重建、肌腱皮瓣重建或复合组织移植，该升支可能是一个很好的替代选择。
临床问题/证据水平：诊断，II 级。
