摘要
目的为指掌侧固有动脉中节中段背侧血管支为蒂的穿支皮瓣提供较为翔实的解剖及临床应用依据。方法2016年12月-2017年3月,利用5具福尔马林固定的成人尸手标本,在显微镜下对示、中、环、小指指掌侧固有动脉中节背侧血管支及所在区域进行显微解剖,高分辨相机拍照,PhotoshopCS4软件测量分析,观察其分支点位置,角度、走行长度、小分支数量、吻合情况并获得观测数据。结果解剖后观测统计得出指掌侧固有动脉背侧指中节中段支,示、中、环指起点平均外径≥0.30 mm,止点平均外径≥0.20 mm;小指起点处平均外径≥0.25 mm,止点处平均外径≥0.10 mm。小分支数量2~5支,与指掌侧固有动脉角度(52.48±8.29)°,走行长度为指掌侧固有动脉与该血管分支点到甲襞中内1/3处的距离,在甲襞止点处尺桡两侧血管支与两侧指掌侧固有动脉远节背侧穿支相互形成"π"形血管网状结构。指掌侧固有动脉中节中段背侧血管支向末节走行,在甲襞中内1/3与对侧同名血管及两侧指掌侧固有动脉末节背侧支相吻合,是一条贯穿中节及末节指背的外径粗大走行较直的主干型血管。结论以指掌侧固有动脉中节中段背侧血管支为蒂的顺转或逆转皮瓣解剖结构固定、操作简单、快捷,可能是修复手指近指骨间关节指背、中节指腹末节指缺损,末节指端、指腹缺损一种较为理想的手术方式。
Objective To provide a more detailed anatomical and clinical application basis for proper palmar digital artery perforator flaps of middle phalange.Methods Five formalin-fixed adult cadavers hand specimens were choosen from December 2016 to March 2017.The dorsal branches of middle phalange digital artery and artery area of index finger,middle finger,ring finger,little finger were observed with microanatomy by microscopically,taking pictures with high-resolution camera,measurement and analysis with PhotoshopCS4 software,the branch point position,angle,length,number of small branches,and anastomoses were observed,and observed data was gotten.Results The starting point mean outer diameter of dorsal branches of middle phalange digital artery of index finger,middle finger,ring finger,and little finger was≥0.30 mm,the end mean outer diameter was≥0.20 mm.The starting point mean outer diameter of little finger was≥0.25 mm,the end mean outer diameter was≥0.10 mm.There were 2-5 small branches,with a 53.5°±10.5°mean arterial angle.The lenth was the finger arterial blood vessel branch points to within 1/3 in nail nailfold.It was a"π"shape vasoganglion structure between the both sides blood vessel branch of the end nail fold and both sides of the distal phalanx dorsal artery perforator.Dorsal branches of middle phalange digital artery was anastomosed with contralateral same blood vessels and both sides dorsal branches of distal phalange digital artery at the inner 1/3 of nail fold.And it was a straight trunk blood vessel through outer diameters of middle phalange and distal phalange.Conclusion Flap retrograde or antegrade anatomical structure of dorsal branches of middle phalange digital artery are fixed,easy and fast to operate.It is a ideal operation method of repairing the digital dorsal defect of proximal interphalangeal joints,finger pulp defect of middle phalange,finger tip and pulp defect of distal phalange.
作者
乔悾
王飞
张立岳
董文秀
木仁
郝宝平
万文婷
胡燊
高尚
QIAO Kong;WANG Fei;ZHANG Li⁃yue;DONG Wen⁃xiu;MU Reng;HAO Bao⁃ping;WANG Wen⁃ting;HU Shen;GAO Shang(Department of Hand and Foot Surgrey,Inner Mongolia Bayannaoer City Hospital,Bayannaoer,Inner Monggplia 015000,China)
出处
《解剖学研究》
CAS
2020年第5期451-456,共6页
Anatomy Research
基金
内蒙古自治区巴彦淖尔市科技计划项目(K201746)
关键词
指掌侧固有动脉
穿支
甲襞
近指骨间关节
Proper palmar digital artery
Perforator
Nail fold
Proximal interphalangeal joints
作者简介
通信作者:高尚,E⁃mail:jiepouxuegaoshang@163.com
