第4掌背动脉逆行岛状皮瓣的解剖及临床应用

Anatomy and clinical application of the fourth dorsal metacarpal artery retrograde island flap

目的：通过活体及标本解剖观测，为第４掌背动脉逆行皮瓣的临床应用提供解剖学依据。方法：通过对４０例活体（８０侧手）用Ｄｏｐｐｌｅｒ血流探测仪检查第４掌背动脉的出现率。８例新鲜的成人手标本灌注红色乳胶，２例在第３指掌侧总动脉起点处加压灌美蓝。结果：第４掌背动脉的出现率为９６％。以其血供来源将其分为３型。其血供的基础是第４掌背动脉远近侧轴点处２条较粗大的皮支，皮支之间在筋膜层构成了丰富的网状血管结构，在指蹼处与指掌侧总动脉或分支之间有吻合支相连，设计以此吻合支为蒂逆行岛状皮瓣。临床应用１５例，皮瓣全部成活。结论：该皮瓣适宜于修复小指、环指远指节间关节以近的不同平面的皮肤缺损，特别适宜于小指脱套伤的修复。

bjective:To obtain the morphological basis of the fourth dorsal metacarpal arterial flap for repairing the skin defect of the hand.Methods:The fourth dorsal metacarpal artery in 80 hands (40 volunteers) were investigated with Doppler instrument and 8 fresh cadaver hands were dessected after injection of red color rubber.Results:The fourth dorsal metacarpal artery was found in 96%,The artery gives 2 skin branches,which anastomosis in the fasia layer.The branches connect with the common polar digital artery at the finger web.Based on the observation,the fourth dorsal metacarpal arterial reversive island flap can be designed .All 15 flaps were survived in treating the skin defects of the hand.Conclusions:This flap is suitable for reparing the skin defects in the ring finger or little finger.