虎口掌侧动脉背侧穿支蒂跨区供血皮瓣的解剖基础

doi:10.13418/j.issn.1001-165x.2020.02.003

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

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

1.厦门大学附属第一医院翔安院区手足显微外科，厦门 361101； 2.福建医科大学附属第一医院骨科，福州350005；
3.福建医科大学福总临床医学院（联勤保障部队第900医院）基础医学实验室，福州 350025

收稿日期:2019-11-20 出版日期:2020-03-25 发布日期:2020-03-30
通讯作者: 胡德庆，E-mail：hudeqing1987@126.com
作者简介:王田佺（1990-），医师，硕士，研究方向：皮肤软组织损伤与修复，Tel：13665018557，E-mail：861403473@qq.com
基金资助:
原南京军区医学科技创新重大专项（ZX30）

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

1.Department of Hand and Foot Microsurgery, Xiang an District, the First Affiliated Hospital of Xiamen University, Xiamen 361101, China; 2.Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China; 3. Laboratory of Basic Medicine, Fuzhou General Teaching Hospital of Fuzhou Medical University (The 900th Hospital of PLA), Fujian 350025, China

Received:2019-11-20 Online:2020-03-25 Published:2020-03-30

摘要/Abstract

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。

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

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.

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

中图分类号:

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.

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.

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虎口掌侧动脉背侧穿支蒂跨区供血皮瓣的解剖基础

Anatomical basis of the dorsal perforating extended flap based on the palmar artery at the site between the thumb and the index finger

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