CAJ | 학술논문

目的：：探讨实施带腓浅神经营养血管为蒂的皮瓣手术时腓浅神经运动支的安全性。方法：对60侧福尔马林固定的小腿标本进行解剖,观察腓浅神经走行及各肌支的分出点和穿入点的位置,定位采用以腓骨小头和外踝间进行八分法；测量分出点和穿入点与腓骨小头的距离等数据,记录并进行统计分析。结果：腓浅神经腓骨长肌第一、二肌支(Ⅰ型)穿出点均在一区间,穿入点均在三区间；腓浅神经腓骨短肌肌支穿出点均在三区间,而穿入点70%在四区间,30%在五区间；所有肌支由腓浅神经发出后均向后腓侧进入肌腹；腓骨短肌肌支分出点距腓骨小头90.4±23.5mm(44.3~136.5mm)。结论：近侧蒂皮瓣的轴点和远侧蒂皮瓣的近端均应在腓骨短肌肌支分出点之下(腓骨小头下44.3~136.5mm,3区),切取皮瓣时从前往后游离较好。
목적：：탐토실시대비천신경영양혈관위체적피판수술시비천신경운동지적안전성。방법：대60측복이마림고정적소퇴표본진행해부,관찰비천신경주행급각기지적분출점화천입점적위치,정위채용이비골소두화외과간진행팔분법；측량분출점화천입점여비골소두적거리등수거,기록병진행통계분석。결과：비천신경비골장기제일、이기지(Ⅰ형)천출점균재일구간,천입점균재삼구간；비천신경비골단기기지천출점균재삼구간,이천입점70%재사구간,30%재오구간；소유기지유비천신경발출후균향후비측진입기복；비골단기기지분출점거비골소두90.4±23.5mm(44.3~136.5mm)。결론：근측체피판적축점화원측체피판적근단균응재비골단기기지분출점지하(비골소두하44.3~136.5mm,3구),절취피판시종전왕후유리교호。
Objective:To investigate how to shelter the motor branches of superficial fibular nerve during the operation about the fasciocutaneous flap pedicled with superficial fibular nerve and its nutrient vessels. Methods:Sixty cases of formalin marinated a﹣dult leg samples were taken and dissected. The superficial fibular nerve courses and the diverging points and entering points of each muscular branches were observed. The location was done by eight division method between capitulum fibulae and lateral malleolar. The distance data between each diverging point, entering point and capitulum fibulae were measured, recorded, and statistically analyzed. Results:The diverging points of musculus peroneus longus' motor branches I, II were all in interval one and the entering points was in interval three ( Type I);the diverging points of musculus fibularis brevis' motor branches were all in interval three and 70% of the en﹣tering points were in interval four, 30% of the entering points were in interval five. All motor branches erupted from superficial fibular nerve and entered into muscle belly posterolaterally. The distances from the diverging points of musculus fibularis brevis motor branch to capitulum fibulae was 90. 4±23. 5mm (44. 3 ~136. 5mm). Conclusions: The axle of the proximate flap and the proximum of the distal turnover flap should be under the diverging points of musculus fibularis brevis' motor branches (44. 3-136. 5mm to capitulum fib﹣ulae, Interval three) , and it is better to lib the skin flap from anterior surface to posterior surface.