带掌背动脉的逆行掌骨关节面复合组织瓣修复手部骨关节缺损

BONE AND JOINT DEFECTS OF HAND RE-PAIRD BY REVERSE COMBINED FLAP WITHDORSAL METACARPAL ARTERY AND THE OSSEO-ARTICULAR PIECE OF THE MATA CARPI

在手各掌骨间隙背侧，走行有４条掌背动脉，在各掌骨头之间，均发出一条恒定的吻合支，与指掌侧总动脉或其分支相连，构成掌骨掌背动脉的血管吻合网，并有二条小静脉伴行，与腕背侧血管网吻合向腕掌关节和掌骨供血。以掌背动脉为轴心，设计逆行掌骨关节面修复手部关节缺损８例，获得成功。用带伸腱掌骨块和皮肤的复合组织皮瓣，一次修复骨关节缺损合并肌腱和皮肤缺损，方法简单，就地取材，不损伤手部主要的血管和神经，可一次修复多个关节，配合外固定支架，术后立即功能锻炼，保证了骨关节可靠固定和术后早期活动。

AbstractThere are four dorsal metacarpal arteries accom-panied by venulae among each metacarpal,which makedistal intermetacarpal anastomoses between dorsal andpalmar vascular networks. by an anastomotic branchand connect with dorsal carpal rete vasculosum to sup-ply blood for metacarpal and carpometacarpal. We de-signed reverse articular surface of metacarpal by usingthe dorsal metacarpal artery as the axis for repairingbone and joint defects of hand, 8 cases were appliedsuccessfully. For once bone joint and lendon defects ofhand were repaired by reverse combined bone,tendonand flap. This one-stage operation is simple,practicaland effective