第1跖背动脉显微外科解剖类型观察和临床意义

Clinical anatomic type observation of the first metatarsal dorsal artery

目的通过观察国人足部第1跖背动脉的解剖类型及所测得的解剖学数据,为临床显微外科进行修复手和足部合并骨和肌腱外露的皮肤软组织损伤以及手拇指再造时,以取用第1跖背动脉为蒂的皮瓣移植提供解剖学依据。方法选用16具成人尸体双侧足部标本32例,对其第1跖背动脉用游标卡尺进行解剖测量,并对第1跖背动脉测量数据进行统计学分析。结果通过对32例足部标本的测量,第1跖背动脉可分为5种类型。Ⅰ型(肌上型):第1跖背动脉走行于第1骨间背侧肌浅面,共13例(40.6%);Ⅱ型(肌内型):第1跖背动脉穿行于第1骨间背侧肌内部,共11例(34.4%);Ⅲ型(肌下型):第1跖背动脉走行于第1骨间背侧肌深面,共6例(18.8%);Ⅳ型(细小型):第1跖背动脉极其细小,共1例(3.1%);Ⅴ型(缺如型):第1跖背动脉缺如,共1例(3.1%)。第1跖背动脉发出的前、后穿支与跖骨和跖趾关节的距离:后穿支起点至第1跖骨底中点距离为(2.4±0.3)mm;后穿支起点至第1跖骨头中点距离为(10.1±1.0)mm;前穿支起点至跖趾关节中点距离为(7.6±2.7)mm。结论第1跖背动脉对手和足部创伤及拇指再造等皮瓣移植有重要临床参考意义。

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery. Methods The 16 adult cadaver specimens with 32 feet were dissected and meas- ured by vernier caliper. Then the anatomic data of the first metatarsal dorsal artery were analyzed. Results Through the examinations of 32 feet sample, the first metatarsal dorsal artery were classified into 5 types. Type I ： the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle （ 13 sides ,40.6% ）. Type ]] ：the first metatarsal dorsal artery runs in the interior of the first dorsal interosse- ous muscle （llsides,34.4%）. Type re：the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle （6 sides, 18.8% ）. Type IV ： the first metatarsal dorsal artery is slender （ 1 side,3.1% ）. Type V ： the first metatarsal dorsal artery is absent （ 1 side, 3.1% ）. Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery：the vertical distance between the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was （ 2.4 ± 0.3 ） ram, the vertical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was （10.1 ± 1.0） mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso- phalangeal joint was （7.6 ± 2.7 ）mm. Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet＇ s trauma and skin flap transplantation such as thumb reconstruction.