虎口掌侧动脉背侧穿支蒂跨区供血皮瓣的解剖基础

王田佺, 胡德庆, 林海青, 温福利, 薛来恩

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2) : 127-130.

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2) : 127-130. DOI: 10.13418/j.issn.1001-165x.2020.02.003
穿支皮瓣

虎口掌侧动脉背侧穿支蒂跨区供血皮瓣的解剖基础

  • 王田佺1, 胡德庆2, 林海青3, 温福利3, 薛来恩3
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Anatomical basis of the dorsal perforating extended flap based on the palmar artery at the site between the thumb and the index finger 

  • WANG Tian-quan1, HU De-qing2, LIN Hai-qing3, WEN Fu-li3, XUE Lai-en3
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摘要

目的 探讨虎口掌侧动脉背侧穿支形态学特征,为虎口掌侧动脉背侧穿支皮瓣设计提供解剖学基础。  方法 用30侧灌注红色乳胶的成尸手标本,通过巨微解剖、血管铸型等方法,重点观测:①虎口背侧营养血管的起源、走行与分布;②虎口掌侧动脉背侧穿支与虎口背侧血管的吻合特点。另1侧灌注红色乳胶的新鲜标本进行摹拟手术设计。   结果 虎口背侧血供属多源性,由虎口掌侧动脉(示指桡掌侧固有动脉、拇指尺掌侧固有动脉)背侧穿支和虎口背侧动脉(第1掌背动脉)分支供养。①第1掌背动脉恒定起自桡动脉,走行于第1掌骨间隙,分出桡侧、尺侧和中间3个终支,有桡神经浅支发出的同名指背皮神经伴行;②虎口掌侧动脉向虎口背侧发出尺侧、中间和桡侧穿支,与第1掌背动脉分支形成恒定的吻合,营养虎口背侧皮肤。 结论 以虎口掌侧动脉背侧穿支为蒂,可形成跨区域供血虎口背侧皮瓣转位修复示指近侧段、鱼际部和拇指软组织缺损。

Abstract

Objective To explore the morphological characteristics of the dorsal perforators from the palmar artery at the site between the thumb and the index finger, and provide the anatomical basis for the design of the dorsal perforator flap based on the palmar artery. Methods Thirty adult upper limb specimens injected with red latex were dissociated to observe the following contents by means of vascular cast and macro-micro-anatomy: ①The origin, courses and distribution of the dorsal nutrient vessels at the site between the thumb and the index finger; ②The anastomotic characteristics of the dorsal perforators of the palmar artery and the dorsal vessels at the site between the thumb and the index finger. One fresh specimen perfused with red latex was performed as a mimic operation. Results The blood supply at the site between the thumb and the index finger was multi-sources, which was provided by the dorsal perforators from the palmar artery (the radial palmar digital artery of the index finger and the ulnar palmar digital artery of the thumb) and the branches from the dorsal artery (the first dorsal metacarpal artery). ①The first dorsal metacarpal artery constantly originated from the radial artery and ran in the first metacarpal bone interval, and finally divided into three terminal branches: radial branch, ulnar branch, and intermediate branch,accompanied with homonymous dorsal digital cutaneous nerve from the superficial branch of radial nerve. ②The palmar artery sent out the radial, ulnar, and intermediate perforators towards the dorsum, which formed constant anastomosis with the branches of the first dorsal metacarpal artery to nourish the dorsal skin. Conclusions The dorsal perforator flap based on the palmar artery at the site between the thumb and the index finger possessed cross regional blood supply and could be transposed to repair the defects in the proximal part of the index finger, the thenar region, as well as the thumb.

关键词

示指桡掌侧固有动脉 /  拇指尺掌侧固有动脉 /  第1掌背动脉 /  穿支皮瓣 /  虎口

Key words

The radial palmar digital artery of the index finger /  The ulnar palmar digital artery of the thumb /  The first dorsal metacarpal artery /  Perforator flap /  Site between the thumb and the index finger

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王田佺, 胡德庆, 林海青, 温福利, 薛来恩. 虎口掌侧动脉背侧穿支蒂跨区供血皮瓣的解剖基础[J]. 中国临床解剖学杂志. 2020, 38(2): 127-130 https://doi.org/10.13418/j.issn.1001-165x.2020.02.003
WANG Tian-quan, HU De-qing, LIN Hai-qing, WEN Fu-li, XUE Lai-en. Anatomical basis of the dorsal perforating extended flap based on the palmar artery at the site between the thumb and the index finger [J]. Chinese Journal of Clinical Anatomy. 2020, 38(2): 127-130 https://doi.org/10.13418/j.issn.1001-165x.2020.02.003
中图分类号: R323.71    R322.121   

参考文献

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原南京军区医学科技创新重大专项(ZX30)

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