足底外侧动脉第5跖骨穿支皮瓣解剖与临床应用

Anatomy of perforator flap of the lateral plantar artery of the fifth metatarsal bone and its clinical application

目的 探讨足底外侧动脉第5跖骨穿支皮瓣应用解剖及临床应用疗效. 方法 根据30侧动脉内灌注红色乳胶的成人足标本解剖观测研究,获得足底外侧动脉第5跖骨穿支起源、走行、分支分布及第5跖骨穿支与足背外侧区血管吻合特点, 在前足外侧设计并切取足底外侧动脉第5跖骨穿支皮瓣转位修复前足缺损创面7例.结果 本组皮瓣术后全部顺利成活,创面一期愈合.术后经1~18个月随访,皮瓣质地良好,供区未发现穿鞋不适、行走受限等异常,患者对治疗效果满意.结论 足底外侧动脉第5跖骨穿支解剖恒定,血供丰富,手术操作简单,是修复前足软组织缺损中小创面较为理想的皮瓣.

Objective To explore the clinical anatomy of perforator flap of the lateral plantar artery of the fifth metatarsal bone and its application. Methods Investigated 31 sides of adult foot cadavers which were injected with red latex. The origin, course, branches, distribution and anastomosis of the lateral plantar artery of the fifth metatarsal bone with the vessels in lateral dorsum of foot were observed. In the light of the anatomical basis, we transferred the designed perforator flap of the lateral plantar artery of the fifth metatarsal bone to repair the forefoot defects in 7 cases. Results After the operation which based on the anatomy of perforator flap of the lateral plantar artery of the fifth metatarsal bone, all the flaps were survived and the wounds got healed by first intention. In the follow-up period of 1~18 months, the flaps had good textures, no discomfort of wearing shoes or limited walking, all 7 patients were satisfied with the treatment effect. Conclusion As the surgical procedure is uncomplicated, the perforator flap of the lateral plantar artery of the fifth metatarsal bone which had constant anatomical structures and rich blood supply, is ideal for repairing the small and medium-size forefoot soft tissue defects.