넓적다리 앞가쪽유리피판술을 위한 가쪽넓은근의뿌리동맥과 피부분포영역
Pedicle and Skin Territory of the Vastus Lateralis Muscle for theAnterolateral Thigh Free Flap
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넓적다리 앞가쪽은 피판술에 많이 이용되는 부위로 관통동맥의 분지양상과 피부분포영역이 중요하다. 이에 저자들은 한국인 시신 110구를 이용한 해부학적 방법과 방사선학적 방법에서 위앞엉덩뼈가시(A)와 무릎뼈 가쪽모서리의 가운데 지점(B)을 연결하는 선 AB를 기준으로 A에서 B방향의 거리를 X값으로 정하고, 수평방향의 거리를 Y값(가쪽방향 -, 안쪽방향 ±)으로 정한 후 가쪽넓은근 주변을 계측하여 앞가쪽 넓적다리부위에서 가쪽넓은근을 지나 피부에 분포하는 관통동맥의 피부분포영역을 조사하여 다음과 같은 결과를 얻었다. 가쪽넓은근의 뿌리동맥은 가쪽넙다리휘돌이동맥의 내림가지에서 시작하여 좌표값(X : 20.8 cm, Y : -1.2 cm)에위치하였고 길이는 91.7 mm, 바깥지름은 2.7 mm였다. 관통동맥은 평균 3.2±1.5개였고, 점 A에서 점 B방향으로 20.8 cm 지점에서 아래가쪽으로 6×18 cm2 크기의 피부에 분포하였다 이러한 실험 결과는 넓적다리 앞가쪽부분의 피부에 분포하는 동맥에 대한 해부학적 기본자료를 제공하며 이부위를 이용하는 피판술에 있어 피판의 크기와 위치를 결정하는데 유용한 지표로 사용될 것으로 생각된다.
Abstract
The pattern of location, perforator artery and skin territory of the descending branch of the lateral circumflex femoral artery are very important to the anterolateral thigh free flap surgery. The author studied the pattern of vascularization of the anterolateral thigh in 110 Korean cadavers using macroscopic dissection and radiographic methods. The location of the points in this study were expressed as XY coordination in reference to the line between ASIS and center of the lateral margin of the patella. The location of pedicle of the vastus lateralis muscle at XY coordination valued X: 20.8±6.0 cm, Y: -1.2±1.0 cm. The length and external diameter of the pedicle were 91.7±54.9 mm, and 2.7±0.8 mm respectively. The average number of perforator artery to the vastus lateralis muscle were 3.2±1.5. The skin territory of the perforator of the vastus lateralis muscle was 6×18 cm2, its location was 20.8 cm on the line AB. The pattern of distribution and territories of the anterolateral thigh obtained in this study will provide useful anatomical backgrounds for the flap surgery of anterior and anterolateral thigh.
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