摘要目的 为膝降动脉穿支蒂股内侧皮神经营养血管皮瓣提供解剖学基础.方法 在40侧动脉内灌注红色乳胶的成人下肢标本上,以股骨内侧髁为观测标志解剖观测:股内侧皮神经走行与分布;膝降动脉穿支与股内侧皮神经营养血管间的吻合关系.另1侧新鲜标本进行摹拟手术.结果 股内侧皮神经体表投影为腹股沟韧带中点与股骨内侧髁的连线;膝降动脉(髌下支)穿支于股骨内侧髁下缘上约4 cm,在股内侧肌、大收肌腱与股骨内侧髁所围成的三角形凹陷内穿过深筋膜至皮下,并分出众多的细小血管与股内侧皮神经的神经旁和神经干血管链(网)密切吻合,在大腿内侧形成顺沿股内侧皮神经纵轴的血管丛.结论 根据膝降动脉穿支与股内侧皮神经营养血管吻合关系,可形成膝降动脉穿支蒂股内侧皮神经营养血管皮瓣转位修复膝部软组织缺损.

abstractsObjective To provide anatomical basis for the thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators. Methods ① The course and distribution of thigh medial cutaneous nerve. ②Anastomosis between descending genicular artery perforators and thigh medial neurocutaneous vascular, were observed on 40 specimens of adult lower limb perfused with red latex. Mimic operation was performed on one side of fresh specimen. Results ①The line between the midpoint of inguinal ligament and medial femoral condyle can be considered as the projection on body surface of thigh medial cutaneous nerve. ②Perforating branches of descending genicular artery (infrapatellar branch )started from the lower edge of medial femoral condyle about 4 cm, and passed through the deep fascia in which the triangle depression surrounded by the vastus medialis muscle, adductor tendon and the medial femoral condyle to the subcutaneous. They also separated large number of small blood vessels, which closely aligned with the perineural and neural stem vascular chain of thigh medial cutaneous nerve. Then they formated vascular plexus in the upper part of thigh along the thigh medial cutaneous nerve longitudinal axis. Conclusion The thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators can be formed to repair soft tissue defect around knee joint.