感觉性骨皮瓣腓骨瓣：皮瓣神经支配模式的解剖学研究
Sensate osteocutaneous fibula flap: anatomic study of the innervation pattern of the skin flap.
作者信息
Woerdeman L A, Chaplin B J, Griffioen F M, Bos K E
机构信息
Department of Plastic, Reconstructive and Handsurgery, Academic Medical Centre, Netherlands Cancer Institute, Amsterdam.
出版信息
Head Neck. 1998 Jul;20(4):310-4. doi: 10.1002/(sici)1097-0347(199807)20:4<310::aid-hed5>3.0.co;2-1.
BACKGROUND
For oromandibular reconstructions, an osteocutaneous fibula flap provides sufficient bone and pliable skin. Sensory reinnervation could possibly prevent problems in mastication and deglutition.
METHODS
In this anatomic study, 33 cadaver limbs were microsurgical dissected. We investigated the lateral sural cutaneous nerve (LSCN), which supplies sensation to the skin of the lateral lower leg, in relation to the fibula skin flap. The fibula is vascularized by the peroneal vessels via the posterior intermuscular septum. Therefore, the posterior septum determines the center line of the flap design.
RESULTS
The LSCN runs in 74% of the dissections posterior to the posterior septum, whereas an anterior branch was seen in 26%. In 54% of the dissections, the distance to the posterior septum was within 3 cm from the septum, whereas in 86%, the distance was found to be within 4 cm.
CONCLUSION
The skin flap should be designed more posteriorly to achieve maximal reinnervation.
背景
对于口颌面部重建，腓骨骨皮瓣可提供足够的骨组织和柔软的皮肤。感觉再支配可能有助于预防咀嚼和吞咽问题。
方法
在这项解剖学研究中，对33具尸体下肢进行了显微外科解剖。我们研究了为小腿外侧皮肤提供感觉的腓肠外侧皮神经（LSCN）与腓骨皮瓣的关系。腓骨由腓血管通过后肌间隔供血。因此，后间隔决定了皮瓣设计的中心线。
结果
在74%的解剖中，LSCN走行于后间隔后方，而26%可见前支。在54%的解剖中，到后间隔的距离在距间隔3 cm以内，而在86%的解剖中，该距离在4 cm以内。
结论
皮瓣应设计得更靠后，以实现最大程度的再支配。
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