足底的血管构筑与跖弓皮瓣、肌皮瓣对足跟缺损的修复

摘要

Objective: To provide anatomic basis of 3 set vascular network for using arcus plantaris skinor myocutaneous flap to repair the heel defect. Methods: 20 preserved adult cadavers and 4 adultcadavers perfused with red latex via artery were dissected, the origins, courses, branches, distri-butions and anastomosis of medial and lateral plantar arteries were observed. Results: Therewere 3 set vascular networks in sole of feet. 1. Medial branch and lateral branch of medial plan-tar artery course deep to the abductor hallucis, forming medial vscular network in sole. 2. Lateralbranch of medial plantar artery anostomosed with minor branch of lateral plantar artery forms thesuperficial plantar arch between the aponeurosis plantaris and flexor digitorum brevis. 3. Medialbranch of medial plantar artery anostomosed with main branch of lateral plantar artery forms thedeep plantar arch between oblique head of adductor hallucis and interosseus muscles. Conculsion:The 3 set vascular network provide reliable blood supply for skin or myocutaneous flap. Espicial-ly medial plantar mycutaneous flap has 2 set of blood supply origining medial and lateral branchesof medial plantar artery. If one branch was damaged, the other would nourishes the flap.%目的：用跖弓皮瓣、肌皮瓣修复足跟缺损，提供足底三套血管网分布特点的解剖学依据。方法：在20例福尔马林、4例红色乳胶灌注的成人尸体标本上，观察足底内、外侧动脉的起始、行径、分支及其吻合情况。结果：足底共有三套血管网供血：1.足底内侧动脉的内、外侧支在 展肌深面分支分布，形成足底内侧血管网。2．足底内侧动脉外侧支与足底外侧动脉的分支在足底腱膜与趾短屈肌之间吻合形成足底浅弓。3．足底内侧动脉的内侧支与足底外侧动脉的主干在 收肌斜头与骨间肌之间形成足底深弓。结论：足底的三套血管网，为利用跖弓皮瓣、肌皮瓣修复提供了可靠的供血系统，足底内侧动脉的内、外侧支的两套血供，为足跟部带蒂皮瓣、肌皮瓣的修复提供了"双保险"。