Mairesse J L, Mestdagh H, Bailleul J P, Depreux R
Acta Anat (Basel). 1981;110(3):270-6.
The tensor fascia lata is a short flat muscle arising from the anterior superior iliac spine and inserting into the fascia lata at mid thigh. It is supplied by three arterial pedicles of unequal importance, branching from the external iliac, gluteal and deep femoral arteries. The 'dominant' blood supply is carried by the lateral circumflex femoral artery which comes from the deep femoral and enters the muscle, approximately 8.8 cm beneath the anterior superior iliac spine. This vessel varies in size from 2 to 3.5 mm; it is 8 cm long but can be lengthened by ligating the branch for the vastus lateralis. On the deep sheath of the iliotibial tract it gives off three branches which supply each third of the fleshy body. The upper branch runs vertically to the iliac insertion of the muscle but not so far as the iliac crest and provides no cutaneous twig. On the contrary, the mid branch runs transversally through the muscle and sends perforating vessels to the skin overlying the fascia lata 6--7 cm below the anterior superior iliac spine. The descending branch runs parallel to the muscular fibers of the muscle and supplies the skin of the lateral lower thigh down to 8 cm above the knee. So the pedicle supports an area of the skin which is double the length (22 cm) and triple the width (9.5 cm) of the fleshy body. The tensor fascia lata including the two layers of the iliotibial tract but excluding its upper insertion, together with the skin of the lateral aspect of the thigh can be safely used as a myocutaneous flap for covering defects of the trochanteric, ischial and sacral areas.
阔筋膜张肌是一块短而扁平的肌肉,起自髂前上棘,止于大腿中部的阔筋膜。它由三条重要性不等的动脉蒂供血,这些动脉蒂分别发自髂外动脉、臀动脉和股深动脉。“主要”血供由旋股外侧动脉提供,该动脉来自股深动脉,在髂前上棘下方约8.8厘米处进入肌肉。该血管直径在2至3.5毫米之间;长8厘米,但可通过结扎股外侧肌的分支来延长。在髂胫束的深面,它发出三个分支,分别供应肌肉实体的三分之一。上支垂直走向肌肉的髂骨附着处,但未达髂嵴,也不发出皮支。相反,中支横向穿过肌肉,并向髂前上棘下方6 - 7厘米处阔筋膜上方的皮肤发出穿支血管。下支与肌肉纤维平行走行,供应大腿外侧下部直至膝关节上方8厘米处的皮肤。因此,该蒂所供应的皮肤面积是肌肉实体长度(22厘米)的两倍、宽度(9.5厘米)的三倍。包括髂胫束两层但不包括其上部附着处的阔筋膜张肌,连同大腿外侧的皮肤,可安全地用作肌皮瓣,用于覆盖转子区、坐骨区和骶骨区的缺损。