掌短肌皮瓣的临床应用

Clinical application of the palmaris brevis musculocutaneous flap

目的研究掌短肌皮瓣的应用解剖及临床应用掌短肌皮瓣修复拇指指腹缺损的效果。方法选择３０侧灌注红色乳胶成人上肢标本，观测掌短肌皮瓣的血供、神经分布；临床上对９例拇指指腹缺损的病例，应用吻合血管的掌短肌皮瓣进行修复。结果掌短肌皮瓣的血供有４个来源：即尺动脉干、掌浅支的肌皮支和皮支、掌深支和小指尺侧固有动脉的肌皮支。其静脉回流为上述动脉的伴行静脉。感觉神经为尺神经浅支和尺神经的尺动脉支。临床９例拇指指腹缺损，应用掌短肌皮瓣进行修复全部成功。结论掌短肌皮瓣质地与拇指指腹相似，血供丰富，可带感觉神经，是修复拇指较大面积缺损的供区之一。

Objective To study of applied anatomy of the palmaris brevis musculocutaneous flap and to repair of pulp defect of thumb by free the palmaris brevis musculocutaneous flap. Methods The distributions of vascularis and nerves of the palmaris brevis musculocutaneous flap were observed on 30 upper limbs which were injected red latex. Nine cases who sufferd from pulp defects of thumb were treated by free the palmaris brevis musculocutaneous flap. Results There were four sources of blood supply to palmaris brevis musculocutaneous flap ;ulnar arterial trunk,musculocutaneous and cutaneous branches of superficial palmar branch,the musculocutaneous branches from pro fund branch of ulnar artery and the proper volar ulnar digital artery of little finger..The venous drainages of the flap were venae comitantes of arteries mentioned above, nine cases who suffered from pulp defects of thumb were treated by free the palmaris brevis musculocutaneous flap successfully. Conclusions The palmaris brevis musculocutaneous flap and pulp of thumb have similar characteristics. The blood supply to the palmaris brevis musculocutaneous flap was rich,it could be used as a sensory flap and was one of good donor regions for repairing large pulp defects of thumb.