【摘要】 目的:为应用以膝降血管为蒂股骨胫骨联合骨膜瓣移位修复股骨中下段骨不连提供解剖学基础。方法:用30侧经动脉红色乳胶灌注的成人下肢标本,解剖观测膝降血管起点、走行、分支及分布,并测量30侧成人股骨干中段1/2处及中下1/3交界处的周径。结果:膝降动脉起自股动脉,下行于股内侧肌后内侧面,在距膝关节间隙水平上5.9±1.2cm处,分为横支及纵支(髌下支),横支紧贴股骨下端向前外侧走行,沿途发出骨膜支分布于股骨内侧髁;纵支继续沿收肌腱板及收肌结节前面下行至膝关节间隙水平,后折向前横行于膝关节囊表面,向下发出分支与周围动脉骨膜支在胫骨内侧上段吻合成血管网。结论:分别以膝降动脉横支及纵支为蒂切取股骨内侧髁骨膜瓣和胫骨骨膜瓣,向上移位修复股骨中下断骨不连,形态学上是可行。更多还原

【Abstract】 Objective:To provide anatomical basis for transposition of the medial condyle femoral and tibial periosteal flap pedicled with descending genicular vessels for repairing the femur’ s nonunion. Methods: The origin, course, branches andanastomosis of the inferior patellar of the descending genicular arteries were observed on 30 adult cadavers perfused with red latex and the perimeters measured at half part and third part below the femur of 30 adult cadavers. Results: The descending genicular artery descends from the femoral artery to the back and inner side of medial vastus muscle and at the level of 5. 9 ±1. 2cm above articular space,grous into two branches, the horizontal branches and the vertical branches. The horizontal branches circle around the lower part of the femur,giving off the peiosteal branches, covering the medial condyle femoral. The vertical branches continue to descend along the tuber adductor and the tendon of the adductor, crossing the surface of articular capsular at the level of articular space,giveing off branches to anastomose with the surrounding peiosteal branches at superior parts of medial tibital periostum. Conclusion: Theoretically, the medial condyle femoral flap with the horizontal branches and the tibial periosteal flap with the vertical branches can be transposed upward? for the repar of femur s nonunion.更多还原