中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2013年
1期
56-59
,共4页
郝攀登%郑和平%林涧%张发惠
郝攀登%鄭和平%林澗%張髮惠
학반등%정화평%림간%장발혜
小指尺掌侧动脉%尺动脉腕上皮支%穿支皮瓣%应用解剖
小指呎掌側動脈%呎動脈腕上皮支%穿支皮瓣%應用解剖
소지척장측동맥%척동맥완상피지%천지피판%응용해부
Ulnar palmar digital artery of the little finger%Wrist-skin artery spring from ulnar artery%Perforator flap%Applied anatoruy
目的 探讨小指尺掌侧动脉穿支和尺动脉腕上皮支降支的解剖学特征,为临床尺侧手掌及小指软组织缺损的重建提供新术式. 方法 选用30侧经动脉内灌注红色乳胶的成人上肢标本,以第5掌骨头为观测标志点,手术放大镜下重点解剖观测:①小指尺掌侧动脉穿支的起源、外径、分支与分布、主干长度及主干到第五掌骨头的最短距离；②尺动脉腕上皮支降支的走行及分布.另选1侧新鲜标本进行摹拟手术设计. 结果 小指尺掌侧动脉93.3％起自掌浅弓凸侧的尺侧缘,6.7％由第3掌心动脉与掌深弓发出的分支汇合而成.不同起源的小指尺掌侧动脉发出的穿支穿出深筋膜位置相对恒定,穿出点位于第五掌骨头上(1.3 ±0.3)cm处,由小鱼际浅层肌(小指短屈肌与小指展肌)与第五掌骨之间穿出至皮下,与尺动脉腕上皮支降支形成直接或间接吻合.小指尺掌侧动脉穿支起始外径(0.8±0.4)mm,穿支动脉干长(2.0 ±0.6)cm.结论 小指尺掌侧动脉穿支与尺动脉腕上皮支吻合点位置较固定.以小指尺掌侧动脉穿支为蒂设计皮瓣,血供可靠,转位灵活,可用于修复尺侧手掌及小指软组织缺损.
目的 探討小指呎掌側動脈穿支和呎動脈腕上皮支降支的解剖學特徵,為臨床呎側手掌及小指軟組織缺損的重建提供新術式. 方法 選用30側經動脈內灌註紅色乳膠的成人上肢標本,以第5掌骨頭為觀測標誌點,手術放大鏡下重點解剖觀測:①小指呎掌側動脈穿支的起源、外徑、分支與分佈、主榦長度及主榦到第五掌骨頭的最短距離；②呎動脈腕上皮支降支的走行及分佈.另選1側新鮮標本進行摹擬手術設計. 結果 小指呎掌側動脈93.3％起自掌淺弓凸側的呎側緣,6.7％由第3掌心動脈與掌深弓髮齣的分支彙閤而成.不同起源的小指呎掌側動脈髮齣的穿支穿齣深觔膜位置相對恆定,穿齣點位于第五掌骨頭上(1.3 ±0.3)cm處,由小魚際淺層肌(小指短屈肌與小指展肌)與第五掌骨之間穿齣至皮下,與呎動脈腕上皮支降支形成直接或間接吻閤.小指呎掌側動脈穿支起始外徑(0.8±0.4)mm,穿支動脈榦長(2.0 ±0.6)cm.結論 小指呎掌側動脈穿支與呎動脈腕上皮支吻閤點位置較固定.以小指呎掌側動脈穿支為蒂設計皮瓣,血供可靠,轉位靈活,可用于脩複呎側手掌及小指軟組織缺損.
목적 탐토소지척장측동맥천지화척동맥완상피지강지적해부학특정,위림상척측수장급소지연조직결손적중건제공신술식. 방법 선용30측경동맥내관주홍색유효적성인상지표본,이제5장골두위관측표지점,수술방대경하중점해부관측:①소지척장측동맥천지적기원、외경、분지여분포、주간장도급주간도제오장골두적최단거리；②척동맥완상피지강지적주행급분포.령선1측신선표본진행모의수술설계. 결과 소지척장측동맥93.3％기자장천궁철측적척측연,6.7％유제3장심동맥여장심궁발출적분지회합이성.불동기원적소지척장측동맥발출적천지천출심근막위치상대항정,천출점위우제오장골두상(1.3 ±0.3)cm처,유소어제천층기(소지단굴기여소지전기)여제오장골지간천출지피하,여척동맥완상피지강지형성직접혹간접문합.소지척장측동맥천지기시외경(0.8±0.4)mm,천지동맥간장(2.0 ±0.6)cm.결론 소지척장측동맥천지여척동맥완상피지문합점위치교고정.이소지척장측동맥천지위체설계피판,혈공가고,전위령활,가용우수복척측수장급소지연조직결손.
Objective Through investigating the anatomical features of the perforator from the ulnar palmar digital artery of the little finger and the dorsal descending branch of the ulnar artery,to establish a new approach for the reconstruction of sofi tissue defect of the ulnar palm and the little finger.Methods The fifth caput metacarpale was taken as the observation points on 30 specimens of adult human upper limb perfused with red latex.Something as follows were observed under surgery magnifier:①The origin,external diameter,branches,distribution and the backbone length of the perforator of the ulnar palmar digital artery of the little finger;the distance from the fifth caput metacarpale to the perforate artery ; ② The route and distribution of the dorsal descending branch of the ulnar artery.Mimic operation was performed on another fresh specimen.Results The origin of the ulnar palmar digital artery of the little finger has two different type:93.3％ spring from the external of the arcus volaris superficialis,6.7％ formed by the combination of the third arteriae metacarpeae palmares and the branch from arcus volaris profundus.Although it has two different origins,the perforator has only one piercing point,which located at (1.3 ±0.3)cm upon the fifth caput metacarpale.The perforator,ultimately,combines with the descending branch of the ulnar artery after it pass through the slot between the muscle tendon of hypothenar superficial layer (the flexor digiti minimi brevis and the abductor digiti minimi) and the fifth metacarpale bone.External diameter of the perforator was (0.8 ± 0.4) mm and the backbone length was(2.0 ±0.6)cm.Conclusion The location of the anastomose point between the perforator,which springs from the ulnar palmar digital artery of the little finger,and the dorsal descending branch of the ulnar artery is constant.The perforator flap based on the perforator of ulnar palmar digital artery of the little finger,with sufficient blood supply,can be transferred flexiblely,and can be designed to repaire the defect of soft tissue on the ulnar palm and the little finger.
