掌背动脉蒂逆行掌骨瓣移位治疗指骨骨折不连接

Clinical application of reversed metacarpal bone flap with dorsal metacarpal artery for phalangeal nonunion

为设计以掌背动脉为蒂的逆行掌骨瓣移位，对１２侧新鲜成人上肢标本进行解剖观察，发现手的掌背动脉在指蹼处与指革侧总动脉有恒定的吻合支．并发出１～３条小分支至２～５掌骨基底部．临床应用掌背动脉蒂逆行掌骨瓣移位治疗指骨骨折不连接６例，掌骨瓣最大１．２ｃｍ×０．５ｃｍ×０．５ｃｍ，最小０．７ｃｍ×０．５ｃｍ×０．５ｃｍ。指骨均在２．５～３个月内骨性愈合，经术后８～１０个月随访，按ＴＡＭ标准评价，关节功能恢复优良率达８０％．本术式提供有血运的活骨，加速骨折愈合，为治疗指骨骨折不连接提供了一个好的手术方法．

With the blood vessels infused with dye, 12 fresh specimens of adult.cadaver hands were dissected.Anastomoses between dorsal metacarpal arteries and common palmar digital arteries or their branchesalways presented at the web spaces. There were branches to the periosteum of metacarpal bases.Apedicled metacarpal bone flap was designed with dorsal metacarpal artery as Pedicle.Six patients of phalangeal nonunion were treated. The bones healed at 2. 5--3 month3.The patients were followed up for8￣ 10 months postoperatively. The union of bone was achieved and the rate of functional restoration was 80%.