中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (5): 514-517.

• 应用解剖 • 上一篇    下一篇

腕部掌侧带血供皮瓣游离移植修复手指皮肤缺损的应用解剖研究

赵民1, 吴金英2, 袁作雄2, 李大村1, 李建锋1, 刘井达1
赵亮1, 李海雷1, 王晓磊1, 张文桐1, 田德虎3, 邵新中3   

  1. 1.北京市顺义区医院上肢外科,  北京   101300;    2.首都医科大学燕京医学院解剖教研室,  北京   101300;
    3.河北医科大学第三医院手外科,  石家庄   050051
  • 收稿日期:2013-04-07 出版日期:2013-09-25 发布日期:2013-10-16
  • 通讯作者: 吴金英,副教授, E-mail:zhaomin699@163.com
  • 作者简介:赵民(1968-),男,北京人,硕士,副主任医师,研究方向:手部功能重建,Tel:010-69423220
  • 基金资助:

    首都卫生发展科研专项基金资助项目(2011-7081-01)

Applied anatomy study of vascularized flap from the volar aspect of the wrist to repair soft tissue defects in the finger 

ZHAO Min 1, WU Jin-ying2, YUAN Zuo-xiong2, LI Da-cun1, LI Jian-feng1, LIU Jing-da 1, ZHAO Liang1, LI Hai-lei1, WANG Xiao-lei 1 ,ZHANG Wen-tong 1, TIAN De-hu 3,  SHAO Xin-zhong3   

  1. 1.Department of Upper Limber Surgery, Beijing Shunyi Hospital of China Medical University, Beijing 101300, China;  2.Department of Anatomy, Capital Medical University Yanjing Medical College, Beijing 101300, China;  3.Department of Hand Surgery, the Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 050051, China
  • Received:2013-04-07 Online:2013-09-25 Published:2013-10-16

摘要:

目的 介绍腕部掌侧皮肤带血供游离移植修复手指皮肤缺损的应用解剖学基础。  方法 解剖观测20例成人尸体上肢标本,2例标本做带骨骼动脉铸型,18例标本做肱动脉乳胶灌注。在手术显微镜下进行解剖,观测腕部掌侧皮肤的营养动脉、回流静脉、神经支配来源、其内的掌长肌腱。  结果 腕部掌侧皮肤主要由桡动脉掌浅支分支营养,静脉回流有深浅两种途径,神经支配以正中神经掌皮支为主,桡神经浅支为辅,游离移植可切取面积为2cm×4cm~2 cm×5cm[2cm×(4.42±0.58)cm]。桡动脉掌浅支起始处直径为 (1.25±0.24)mm, 与指动脉直径相仿。  结论 传统的腕部掌侧供皮区皮肤可以形成以桡动脉掌浅支为蒂的复合组织皮瓣游离移植修复手指的皮肤缺损。

关键词:  , 桡动脉掌浅支, 皮肤缺损, 游离移植, 应用解剖, 腕部掌侧

Abstract:

Objective To study the anatomical basis of vascularized flap from the volar aspect of the wrist to repair soft tissue defects in the finger. Methods Twenty upper limb specimens were dissected and observed under operating microscope. Two specimens were made into casting mould of artery with bones, Eighteen specimens were injected with red 1atex in radial artery. The origin, distribution and anastomosis of the vessels, nerves and tendens in the volar aspect of the wrist were oberserved. Results The superficial palmar branch of the radial artery constantly existed, and it was the main nutrient vessel of the wrist volar skin. There were about 2 to 5 branches between the origin and the tubercle of the scaphoid bone. The diameter was (1.25±0.24) mm at the origin, which was similar to the digital arteries .The venous return of wrist volar skin passed through two routes, and the innervations of the wrist volar skin derived mainly from the palmar cutaneous branch of the median nerve.The area of the flap with blood supply from the volar aspect of the wrist was 2cm×(4.42±0.58)cm. Conclusion  The traditional skin donor site from the volar aspect of the wrist can be applied as a free composite tissue flap pedicled by the superficial palmar branch of the radial artery to repair soft tissue defects in the finger.

Key words: Superficial palmar branch of the radial artery, Skin grafting, Free grafting, Applied anatomy, Wrist

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