第二掌背动脉远段皮支链的应用解剖

The second metacarpal dorsal artery distal to the applied anatomy

目的观测第2掌背动脉远段皮支链的组成和分布,为第2掌背动脉皮支链皮瓣修复手指缺损提供解剖学基础。方法选取11例成年新鲜手标本,其中10例标本用红色乳胶灌注尺动脉和桡动脉,1例标本用塑料混合液灌注尺动脉和桡动脉制作铸型标本。解剖观测第2掌背动脉远段发出皮支的走行、皮支链的形成、分布和吻合,血管蒂外径和长度。结果在10例乳胶灌注的标本中,5例男性的第2掌背动脉共发出皮支29支,直径为(0.366±0.129)mm,蒂长为(5.956±1.328)mm;5例女性的第2掌背动脉共发出皮支31支,直径为(0.350±0.110)mm,蒂长为(6.196±1.277)mm。通过两样本t检验比较发现男、女第2掌背动脉动脉的直径和蒂长差异都无统计学意义。第2掌背动脉发出的皮支在手背浅筋膜内相互吻合形成皮支链,营养相应的皮肤。桡神经手背支恒定地穿行在第2掌背动脉远段皮支之间。结论依靠第2掌背动脉远段的皮支链作为第2掌背动脉皮瓣的血管蒂,修复手指皮肤的小面积缺损,并可同时修复损伤部位的感觉。

Bjective To compare the difference of second dorsal metacarpal artery cutaneous branches between adult males and females for providing anatomical basis for second dorsal metacarpal artery flap to repair defect in fingers. Methods 11 cases of fresh adult hand specimens included 10 specimens with red latex to perfuse ulnar artery and radial artery and 1 specimen for making cast specimens using ethyl acetate and plastic powder to perfuse ulnar artery and radial artery perfusion. The distal second dorsal metacarpal artery was dissected to observe the course, distribution and anastomosis of the cutaneous branches, and to measure the diameter and length of the pedicles. Results A total of 29 cutaneous branches were extended from the second dorsal metacarpal artery in 5 male ases. The diameter of the pedicle was （0.366＋0.129） mm, and the length of the pediele was （5.956＋1.328） mm. A total of 31 cutaneous branches were extended from the second dorsal metacarpal artery in 5 female cases, the diameter of the pedicle was （0.350＋0.110） mm, and the length of the pedicle was （6.196＋ 1.277） mm. The t test to compare diameter and length of pedicle of second dorsal metacarpal artery was not significant difference between males and females. Cutaneous branches travel in the superfi- cial fascia of the dorsal hand, and link with each other to nourish skin on the dorsal hand. Dorsal branches of radial nerve were con- stant to travel among the cutaneous branches from the second dorsal metacarpal artery. Conclusion The cutaneous branch of second dorsal metacarpal artery can be used as vascular pedicle to repair small area of skin defect in finger, and to recover sense in finger. It is no gender difference to design second dorsal metacarpal artery cutaneous branches flap.