Wu W C, Chang Y P, So Y C, Yip S F, Lam Y L
Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hong Kong.
Br J Plast Surg. 1993 Sep;46(6):470-9. doi: 10.1016/0007-1226(93)90220-6.
The vascular anatomy of the posterior tibial vessels has been studied in 20 legs of 10 cadavers. The number, size and distribution of the direct cutaneous and direct muscle branches of the posterior tibial vessels were recorded. For analysis, the leg was divided into four equal segments, Zone I being the most distal and Zone IV the most proximal. The direct cutaneous branches were found to cluster mainly around Zone II. The direct muscle branches to the soleus and flexor digitorum longus muscles arose chiefly in Zones II and III. Based on this knowledge, we performed fasciocutaneous, island soleus muscle, musculo-fasciocutaneous and flexor digitorum longus muscle flaps based on the posterior tibial vessels in 12 patients. Four were free fasciocutaneous flaps and eight were pedicled flaps. All flaps survived and there were no major complications. Delayed wound healing was encountered in three patients.
对10具尸体的20条腿的胫后血管的血管解剖结构进行了研究。记录了胫后血管的直接皮支和直接肌支的数量、大小及分布情况。为便于分析，将小腿分为四个相等的节段，I区为最远端节段，IV区为最近端节段。发现直接皮支主要集中在II区周围。比目鱼肌和趾长屈肌的直接肌支主要起源于II区和III区。基于这些认识，我们对12例患者采用胫后血管进行了筋膜皮瓣、岛状比目鱼肌瓣、肌筋膜皮瓣和趾长屈肌瓣手术。其中4例为游离筋膜皮瓣，8例为带蒂皮瓣。所有皮瓣均存活，未出现严重并发症。3例患者出现伤口愈合延迟。
