【摘要】 目的:探讨股前外侧皮瓣移植感觉恢复不良的原因,改进股前外侧皮瓣的设计和感觉重建方法。方法:选择21个成人下肢标本,解剖股外侧皮神经,观察其走行、分布、形态及变异情况;分别测量股外侧皮神经发出后支、前支平面至髂前上棘的距离,以及股外侧皮神经主干在腹股沟韧带下缘穿出点及其发出后支、前支后各平面的外径。结果:股外侧皮神经于髂前上棘下4.8(0~16.9)cm和14.2(6.7~24.1)cm发出后支和前支。股外侧皮神经存在6种分支类型,即普通三支型(9/21)、高位后支型(5/21)、后支缺如型(3/21)、前支缺如型(1/21)、纤细型(2/21)和缺如型(1/21)。股外侧皮神经截面多呈扁圆形,其主干在腹股沟韧带下缘穿出点横径为2.68(1.18~4.52)mm,发出后支后为2.18(0.80~4.10)mm,发出前支后为1.63(0.44~2.60)mm。结论:股外侧皮神经后支的变异是股前外侧皮瓣移植感觉恢复不良的主要原因,于股前外侧中下2/3区域设计皮瓣,选择其主干或发出前支以近节段吻合,可望改善股前外侧皮瓣的感觉功能。更多还原

【Abstract】 Objective: To explore the reasons of poor sensation recovery after anterolateral thigh flap(ALTF) transplantation and to improve the design and sensation reconstruction of ALTF.Methods: Lower limbs from 21 adult cadavers were chosen,and the lateral femoral cutaneous nerves(LFCN) were dissected.Their courses,shape,distribution and anatomic variation were observed,the distance from original sites of LFCN’s posterior and anterior branches to the anterior superior iliac spine(ASIS) were measured,and the external diameter of their main trunks,after piercing out from the inferior margin of inguinal ligament or sending out their posterior branches and their anterior branches,were measured.Results: The plane which the posterior branches sent out from the LFCN located at 4.8(0~16.9) cm below the ASIS.The plane which the anterior branches sent out from the LFCN located at 14.2(6.7~24.1) cm below the ASIS.There were 6 branches of the LFCN,namely ordinary three branches(9/21),high-level posterior branch(5/21),posterior branch absent(3/21),anterior branch absent(1/21),tiny branch,(2/21) and LFCN absent(1/21).The section of the LFCN was oblate,the external diameter of the LFCN,s main trunk after piercing out from the inferior margin of inguinal ligament or sending out its posterior branch and its anterior branch was 2.68(1.18–4.52) mm,2.18(0.80–4.10) mm and 1.63(0.44–2.60) mm,respectively.Conclusion: Poor sensation recovery after ALTF transplantation is due to anatomic variation of the posterior branch of the LFCN.The sensory recovery of ALTF may be improved if the 2/3 low to median part of the anterolateral thigh and the main trunk of the LFCN or its plane before sending out the anterior branch is chosen for anastomosis.更多还原