第3跖背动脉显微解剖及其临床意义

The microscopic anatomy and the clinic research of the third dorsal metatarsal artery

目的为以第3跖背动脉为主要供血的组织移植修复手指脱套伤提供解剖学依据。方法对30侧成人新鲜下肢标本进行解剖及测量,观察第3跖背动脉的来源、走行情况,探讨其临床意义。结果 (1)本组30侧第3跖背动脉均分别在近、远端第3跖骨头水平通过后、前穿支与足底动脉相交通或主要来源于后、前穿支。(2)根据第3跖背动脉来源可将其分为:Ⅰ.足背侧动脉来源为主型,17%(5侧);Ⅱ.足底动脉来源为主型,70%(21侧)。其中IIa.后穿支为主型(含完全来自后穿支),63%(19侧);IIb.前穿支为主型,7%(2侧);Ⅲ.共同来源型,13%(4侧)。第3跖背动脉长度为(4.63±0.23)cm。结论以第3跖背动脉为蒂行足部组织移植修复脱套伤在多数情况下是可行的。

Objective To provide anatomical basis for reconstruction of finger degloving injury by tissue graft using the third dorsal metatarsal artery as the main feeding artery. Method Thirty adult specimens of feet were microdissected and measured in this study. The origin and course of each segment of the third dorsal metatarsal artery were observed and measured, and the functions were analyzed. Results （1） In the 30 sides of specimens, the third dorsal metatarsal artery communicated with the plantar artery through the anterior and posterior perforating branches in the proximal and distal ends of the third metatarsal bone and or mainly originated from the anterior and posterior perforating branches. （2）According to the source of the third dorsal metatarsal artery, these can be divided into： Ⅰ. the dorsal pedal artery was the main source arteries in 5 sides, accounting for 17% of the total; Ⅱ. The plantar artery is the main source artery in 21sides, accounting for 70% of the total. In type IIa, posterior perforating branches are the main source artery （including the full origin from the posterior perforating branches） in 19 sides, accounting for 63% of the total; Ⅱb. anterior perforating branches is the main type 2 sides, accounting for 7% of the total; Ⅲ. shared source artery in 4 sides, accounting for 13% of the total. Conclusion In most cases, foot tissue graft based on the third dorsal metatarsal artery as the main feeding artery is feasible to a certain extent in reconstruction of finger degloving injury.