足背部皮神经营养血管皮瓣的解剖学研究和初步临床应用

发布时间：2018-05-25 08:47

本文选题：足背内侧皮神经 + 足背中间皮神经　；参考：《昆明医学院》2006年硕士论文

【摘要】：目的为足背部皮神经营养血管皮瓣设计提供解剖学依据，并报道其初步临床应用效果。方法 32侧乳胶灌注的成人下肢标本，对足背部皮神经(包括足背内侧皮神经、足背中间皮神经、足背外侧皮神经和腓深神经终末支)及其营养血管进行解剖，观察其起始、直径、走行、分支及分布情况。在此基础上设计足背内侧皮神经营养血管皮瓣2例，足背中间皮神经营养血管皮瓣3例，足背外侧皮神经营养血管皮瓣1例，足背内侧皮神经营养血管联合腓深神经终末支营养血管皮瓣1例应用于临床修复足前端创面。结果 ①足背内侧皮神经续于腓浅神经，行于踝间线时位于中点内侧(0.7±4.3)mm，直径(2.59±0.54)mm，主干于踝间线远端(3.0±1.5)cm处发出分支支配足背内侧和(足母)内侧，第二跖背和趾蹼相对缘及第一跖背皮肤。足背内侧皮神经营养血管平均每侧6.9支，，最为恒定的分支穿深筋膜时分别位于踝间线近端(4.1±0.5)cm，直径(0.81±0.13)mm；第一跖趾关节内侧近端(1.4±0.2)cm，直径(0.48±0.08)mm；第二趾蹼尖近端(1.5±0.3)cm，直径(0.46±0.08)mm。 ②足背中间皮神经续于腓浅神经，行于踝间线时位于中点外侧(1.3±0.6)cm，直径(2.05±0.56)mm，主干于踝间线远端(2.8±1.3)cm处发出分支主要支配第二、三、四跖背及趾蹼相对缘皮肤。足背中间皮神经营养血管平均每侧5.1支，最为恒定的三支分别位于踝间线近端(4.3±0.4)cm，直径(0.82±0.13)
[Abstract]:Objective to provide anatomical basis for the design of neurocutaneous neurovascular flap on the back of foot and to report its preliminary clinical application. Methods 32 sides of adult lower extremity specimens perfused with latex were dissected from dorsal cutaneous nerve (including medial dorsal cutaneous nerve of foot, middle cutaneous nerve of dorsalis pedis, dorsolateral cutaneous nerve of foot and terminal branch of deep peroneal nerve) and their nutrient vessels were observed. Diameter, walk, branch and distribution. On this basis, two cases of medial cutaneous neurocutaneous vascular flap of dorsalis pedis, 3 cases of nutritional vascular flap of medial cutaneous nerve of dorsalis pedis and 1 case of nutrient vascular flap of dorsal lateral cutaneous nerve of foot were designed. One case of dorsal medial cutaneous neurovascular flap combined with nutrient vascular flap of the terminal branch of deep peroneal nerve was used to repair the anterior foot wound. Result 1 the medial dorsal cutaneous nerve of the foot continued at the superficial peroneal nerve, which was located at the medial point of the interankle line at 0.7 卤4.3 mm, with a diameter of 2.59 卤0.54 mm. The main trunk distributed at the distal part of the intermalleolar line (3. 0 卤1.5)cm) to innervate the medial dorsalis pedis and the medial (female) foot, the second metatarsal dorsal and the webbed relative margin and the first dorsal metatarsal skin. The medial dorsal cutaneous nerve of foot had an average of 6.9 vessels per side. The most constant branches were located at the proximal end of the intermalleolar line at 4.1 卤0.5 cm and 0.81 卤0.13 mm in diameter, the first metatarsophalangeal joint was 1.4 卤0.2 cm in diameter, 0.48 卤0.08 mm in diameter, and 1.5 卤0.3 cm in diameter at the proximal end of the second webbed tip, with a diameter of 0.46 卤0.08 mm. in the first metatarsophalangeal joint, the proximal end of the first metatarsophalangeal phalangeal joint was 0.48 卤0.08 mm in diameter. 2 the medial cutaneous nerve of the dorsalis pedis continued at the superficial peroneal nerve, which was located at the lateral side of the midpoint of the intermalleolar line 1.3 卤0.6 cm in diameter and 2.05 卤0.56 mm in diameter. The branch of the trunk at the distal part of the interankle line, 2.8 卤1.3)cm, mainly innervated the second, third and fourth metatarsal dorsal and the relative margin of the toe webbed skin. The nutrient vessels of medial cutaneous nerve of dorsalis pedis averaged 5.1 on each side, the three most constant branches were located at the proximal end of the intermalleolar line (4.3 卤0.4 cm), with a diameter of 0.82 卤0.13).
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R658.3;R322

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