关键词: 腓肠神经, 皮神经营养血管皮瓣, 远端蒂, 肌皮瓣, 血供, 应用解剖

Abstract:

Objective　To explore anatomic features of nutrient vessels of sural nerve and its possibility to supply the myocutaneous flap.　Methods　17 fresh adult leg specimens were used in this study, with 16 cases perfused with red emulsion, and 1 case with gelatin and lead oxide.  The posterior regions of the leg were dissected layer by layer, for investigating the distribution and anastomosis of perforator arteries of myocutaneous arteries with nutrient vessels of sural nerve.　Results　Fibular artery gave off 0 to 3 perforators in the posterolateral muscle interval above the tip of lateral malleolus about 10cm. Terminal branches and lateral calcaneal arteries of this artery in the posterior interval of lateral malleolus continued to send out 2 to 3 skin perforators. 2 to 7 anastomostic branches could be found between nutrient vessels of sural nerve and bilateral myocutaneous perforators of gastrocnemius, which was in the deep fascia. Another 2 to 3 ramus anastomoticus appeared between bilateral myocutaneous perforators, as well, 1 to 3 perforators existed persistantly and anastomosed with each other near the connection of muscle and tendon of gastrocnemius with the range of 2~4 cm.　Conclusions　Permanent anastomosis among myocutaneous perforators of medial and lateral heads of gastrocnemius and nutrient vessels of sural nerve can be found, which is the anatomic basis for designing blood supply of the distal pedicled sural nerve nutrient vessel myocutaneous flap. Closed perforators can be taken as pedicle vessels to repair defects of the individual without suitable perforators.

Key words: Sural nerve, Cutaneous nerve nutrient vessels flap, Distal pedicel, Musculocutaneous flap, Blood supply, Applied anatomy