Ballmer F T, Masquelet A C
Department of Orthopaedic Surgery, University of Berne, Inselspital, Switzerland.
Surg Radiol Anat. 1998;20(5):311-6. doi: 10.1007/BF01630611.
A new fasciocutaneous reversed-flow island flap of the thigh is presented which is independent of the presence of perfused blood vessels below the level of the knee joint-line. The pedicle, which is supplied by the proximal genicular anastomotic network, consists of the osteoarticular branch (OAB) and concomitant veins of the descending genicular artery. Based on cadaver dissections the OAB arose in 23/30 specimens (77%) together with the saphenous artery (SA). In 2/30 specimens (7%) the OAB originated directly from the superficial femoral artery and in 1/30 specimens (3%) the OAB was absent. The OAB gave off one to three cutaneous branches to the overlying skin in 26/30 specimens (87%). We were able to elevate a flap on the osteoarticular branch alone in 57%. Additional length could be added to the pedicle in 33% by including the most proximal part of the saphenous artery together with its first cutaneous branch. Thus, in 90% of the dissections a reversed-flow island flap could be raised which reached the proximal half of the leg, the knee and the most distal part of the thigh. We report our early clinical experience.
本文介绍了一种新的大腿筋膜皮逆流岛状皮瓣，该皮瓣不依赖于膝关节线以下灌注血管的存在。其蒂由近端膝部吻合网络供血，由骨-关节支（OAB）和膝降动脉的伴行静脉组成。基于尸体解剖，在30个标本中有23个（77%）的OAB与隐动脉（SA）一起发出。在30个标本中有2个（7%）的OAB直接起源于股浅动脉，在30个标本中有1个（3%）未发现OAB。在30个标本中有26个（87%）的OAB向上覆皮肤发出1至3条皮支。我们能够单独在骨-关节支上掀起皮瓣的占57%。通过将隐动脉的最近端部分及其第一皮支包括在内，在33%的情况下可以增加蒂的长度。因此，在90%的解剖中可以掀起一个逆流岛状皮瓣，该皮瓣可到达小腿近端一半、膝关节和大腿最远端部分。我们报告了我们早期的临床经验。
