第2指蹼动脉吻合类型及其在手背逆行岛状皮瓣中的意义

Classification of the second web artery and its application in dorasal metacarpal reverse island flaps

目的：研究第２指蹼动脉的吻合类型，为临床以第１指掌侧血管为蒂的手背逆行岛状皮瓣转位提供解剖学基础。方法：使用２２只经血管灌注乳胶的手标本和３４只手动脉铸型标本，对第２指蹼动脉分支分布及与手掌侧和背侧动脉的连接形式等进行解剖观测。结果：第２指蹼动脉恒定存在，外径０．８±０．２ｍｍ，有１～２条伴行静脉。依其与指掌侧总动脉和掌背动脉的连接部位可分为：Ⅰ．中央型（６６．１％）；Ⅱ．掌侧偏型（２５％）；Ⅲ．背侧偏型（７．１％）；Ⅳ．双侧偏型（１．８％）。结论：①第２指蹼动脉吻合恒定存在，这是形成以手掌侧血管为蒂的手背逆行岛状皮瓣的解剖基础；②Ⅰ、Ⅱ型指蹼动脉可为皮瓣提供良好的血供，Ⅲ。

Objective:To investigate the second web artery(SWA) of hand for its classification and application in dorsal metacarpal reverse island flap (DMRIF).Methods:22 latex perfused cadaver hands and 34 artery cast specimens were dissected and measured.Results:The SWA,accompanied by 1 or 2 veins,existed constantly with the diameter 0.8±0.2 mm, and was divided into 4 types:the central type (type Ⅰ,accounted for 66.1%), metacarpal deviated type (type Ⅱ,25%),dorsal deviated type (type Ⅲ,7.1%),bi deviated type (type Ⅳ,1.8%).Conclusions:The constant existence of the SWA was the basis for the use of palmar artery in DMRIF.The SWA of type Ⅰ and Ⅱ were the ideal pedicle of the DMRIF while type Ⅲ and type Ⅳ with high risk.