拇指虎口区挛缩及尺掌侧缺损的皮瓣治疗

Treatment of the Skin Defects of the Functional Area of the Thumb and the Contracture of Adductor Muscle of Thumb with an Island Flap

为拇指虎口区挛缩及尺掌侧缺损的皮瓣治疗提供解剖学基础 ,采用新鲜成人手标本 38个 ,分别进行血管明胶墨汁和 ABS灌注、血管造影、大体和显微解剖观察 .研究结果在第二、第三掌骨背侧有恒定的血管和神经 ,主要由第二掌背动脉提供可靠血供 ,并且在指蹼间隙与掌深弓的深部穿支有吻合支相连 ,还与指掌侧总动脉吻合 .这种血管吻合为本术式的设计提供了形态学基础 .以第二掌背动脉为蒂 ,在距指蹼间隙 1 .5cm处 ,可以作皮瓣面积 4cm× 6cm的逆行岛状皮瓣 ,在临床上可用于修复拇指尺掌侧 (功能区 )

To treat skin defects of the functional area of the thumb and the contracture of adductor muscle of thumb with an island flap. 38 fresh hand specimens were studied with ABS infusion, X ray radiography, gross and microscopic surgery dissection. At the second web space, constant anastomoses were found between the second metacarpal artery and the deep perforating branches of the deep palmar arch as well as the common palmar digital arteries. At the back of the second and third metacarpal area, there exists a constant big metacarpal artery which provides the basis for the retrograde island flap for repairing the skin defects of the functional area of the thumb and the contracture of adductor muscle of thumb.