Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.
Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.
J Plast Reconstr Aesthet Surg. 2019 Apr;72(4):616-621. doi: 10.1016/j.bjps.2018.12.045. Epub 2019 Jan 8.
Rectus femoris is a versatile muscle frequently used as a pedicled flap in reconstructive surgery. The anatomy and blood supply of rectus femoris needs to be clearly understood in order to safely preserve its reconstructive and functional capabilities. Classical anatomical description states that the proximal pedicle insertion into rectus femoris is 10- 15 cm from the anterior superior iliac spine (ASIS). The aim of this study was to dissect and identify the pedicular blood supply to rectus femoris and further map its morphology relative to the ASIS.
A dissection of 20 embalmed thighs from 10 cadavers was conducted. The distance of arterial insertions into rectus femoris from the ASIS were recorded. The cohort was 60% male of median age 79 with statistical significance defined as p < 0.05.
5%, 50%, and 45% of muscles demonstrated 1, 2, and 3 pedicles respectively. The mean distance from the ASIS to insertion of these pedicles was: proximal 13 cm (SD 2.6), middle 15 cm (SD 2.8), and distal 18 cm (SD 4.1). When grouped by number of pedicles, there was no difference in the mean height of proximal insertion. However, there was significant difference in mean intramuscular proximal-distal difference. These results were replicated when data were expressed as % of cadaver height.
This study confirms the pedicular supply of rectus femoris but in contrast to classical literature demonstrates a greater range of pedicle insertions heights. We believe these observations should be considered when safely harvesting the pedicled rectus femoris flap.
股直肌是一种用途广泛的肌肉，经常被用作重建手术中的带蒂皮瓣。为了安全地保留其重建和功能能力，需要清楚地了解股直肌的解剖结构和血液供应。经典的解剖学描述表明，股直肌近端蒂的插入点距离髂前上棘（ASIS）为 10-15cm。本研究的目的是解剖和识别股直肌的蒂状血液供应，并进一步绘制其相对于 ASIS 的形态。
对 10 具尸体的 20 个防腐大腿进行解剖。记录动脉插入股直肌的距离。该队列中男性占 60%，中位年龄为 79 岁，具有统计学意义的定义为 p<0.05。
5%、50%和 45%的肌肉分别显示有 1、2 和 3 个蒂。这些蒂插入 ASIS 的平均距离为：近端 13cm（SD 2.6），中间 15cm（SD 2.8），远端 18cm（SD 4.1）。按蒂的数量分组时，近端插入的平均高度没有差异。然而，在肌内近端-远端的平均差异方面有显著差异。当数据表示为尸体高度的百分比时，得到了相同的结果。
本研究证实了股直肌的蒂状供应，但与经典文献相比，展示了更大范围的蒂插入高度。我们认为，在安全采集带蒂股直肌皮瓣时，应该考虑这些观察结果。
