桡动脉掌浅支蒂腕横纹皮瓣的应用解剖

The applied anatomy and design of wrist crease flap

目的为临床设计切取腕横纹皮瓣提供解剖学基础。方法选取6只新鲜手标本进行红色乳胶灌注,解剖观察桡动脉掌浅支的走行及皮支分布规律和特点。结果桡动脉掌浅支于桡骨茎突掌尺侧自桡动脉发出,起始处直径(1.26±0.36)mm,向鱼际肌走行。桡动脉掌浅支于舟骨结节近侧中间腕横纹处发出皮支,皮支发出处直径(0.23±0.06)mm,供养腕横纹皮肤。结论以桡动脉掌浅支腕横纹皮支供血,以腕横纹皮肤为供区切取游离皮瓣或带蒂转移可以修复手部皮肤软组织缺损,该术式具有血供可靠、不牺牲主干血管,切取安全等优点。

Objective To explore the anatomical basis of blood supply and surgical design method of the wrist crease flap through the anatomical observation of the superficial palmar branch of the radial artery and the cutaneous branches of wrist crease,which could provide anatomical basis for the clinical application of the flap. Methods We dissected 6 fresh hand specimens perfused with red latex to observe the course of superficial palmar branch of the radial artery and the regularity and characteristic of the cutaneous branches of wrist crease＇s distribution. Results Superficial palmar branch of the radial artery started at palm-ulnar side of styloid process of radius from radial artery with an initial diameter of（1.26±0.36）mm,and traveled to the thenar. The cutaneous branches of superficial palmar branch of the radial artery supplied the skin of wrist crease were given off at middle wrist crease with an initial diameter of（0.23 ± 0.06）mm near the proximal aspect of the tubercle scaphoid bone. Conclusion Wrist crease flap was supplied by cutaneous branches of wrist crease from superficial palmar branch of the radial artery. The flap could be designed as a free skin flap or pedicled skin flap to repair the soft tissue defect of hand. The flap had such advantages as reliable blood supply no main vascular sacrifice, and safe surgery.