末节指神经血管显微解剖及临床意义

Microscopic anatomy of nevers and blood vessels of the finger distal phanlanx and its clinical significance

目的为手指末节外伤的修复特别是感觉的恢复提供解剖学依据。方法在10只成人新鲜手标本上，手术显微镜下解剖、观察、测量手指末节区域内神经与血管的走行、分支、分布、外径及二者的位置关系。结果指掌侧固有神经多在末节指动脉弓起始处跨过指动脉行向指腹及侧背部，主干分两支，在半月线平面的横径分别为0．8—1．2mm和0．9～1．4mm。左右分支间相互交叉分布，其分支比伴行的动脉低且稍细。结论指神经多在末节指骨底分支到指腹、指尖和指背，末节断指再植神经、血管吻合的适宜解剖区为远侧指间关节至指甲中173区。

Objective To provide anatomical evidence for the repair of wounds of finger distal phalanx, espe- cially for the recovery of feeling. Methods 10 samples of fresh adult hand were dissected under microscope. The course, branches, distribution and external diameter of nerves and blood vessels in finger distal phalanx and morpho- logical relationship between nerves and vessels were measured. Results Proper palmar digital nerves mostly step over digital arteries at section starts of distal finger arterial arcades and go to finger pulps and latero-backs. Their trunks di- vide into 2 branches. Transverse diameters of interior and exterior branches are 0.8 ~ 1.2 nun and 0.9 ~ 1.4 mm re- spectively at liner semilunaris levels. Distributionsof left and right branches are reciprocal chiasmas. Conclusion Finger nerve mostly ramifies to finger pulp,finger tip and finger back at the level of phalangette bottom. Its branches are lower and thinner than concomitant arteries. The suitable anatomy region for anastomosis of nerves and blood ves- sels is the middlel/3 section from the distal interphalangeal joint to the nail during replanation of amputated finger paratelum.