第2掌背动脉-指背动脉蒂双叶微皮瓣的应用解剖

Applied anatomied study in bilbed micro-flap of second dorsal metacarpal artery and dorsal digital artery

目的观测第2掌背动脉远1/3段、指蹼动脉和指背动脉的走行和分布,为第2掌背动脉-指背动脉蒂双叶皮瓣修复手部软组织缺损提供解剖学资料。方法2018年6月至2019年3月,共34侧成人新鲜上肢标本,24侧桡、尺动脉灌注红色乳胶;10侧灌注铸型材料制作铸型标本。解剖观测第2掌背动脉远1/3段、指蹼动脉和指背动脉的起始、走行和分布。结果第2掌背动脉远1/3段共发出皮支(4+1)条,在掌骨头关节面平面延续为指蹼动脉。指蹼动脉长(2.5+0.6)cm,根据其吻合交通的方式不同可分为4种类型。第2掌背动脉远端向中指和示指近节背侧皮肤各发出1条指背动脉,长(2.6+0.4)cm,直径(0.2+0.1)mm,沿途发出4~6条微细分支,与周围的皮支相互吻合。结论第2掌背动脉和指背动脉解剖恒定,以第2掌背动脉远段-指背动脉为蒂设计示、中指近节双叶指背皮瓣,可转位修复拇指和虎口多处小面积软组织缺损。

Objective To observe the location and the distribution of distal 1/3 segment of the second dorsal metacarpal artery,the finger web artery and the dorsal digital artery,and to provide anatomical data for repairing the soft tissue defect on the hand with bilobed or multi-lobed micro-flap with second metacarpal dorsal artery--dorsal digital artery.Methods From June,2018 to March,2019,34 fresh adult upper limb specimens were selected.The radial and ulnar arteries were perfused with red latex in 24 specimens.The radial and ulnar arteries were infused with cast materials to make cast specimens in 10 specimens.The location and distribution of the distal 1/3 segment of the second dorsal metacarpal artery,the finger web and the dorsal digital artery were observed.Results The distal 1/3 segment of second dorsal metacarpal artery extended(4+1)cutaneous branches,and continued to become the finger web artery at the plane of the articular surface.The length of the finger web artery was(2.5+0.6)cm,and there were 4 types anastomic methods of communication with arteries.The second dorsal metacarpal artery extended 2 finger dorsal artery to the proximal dorsal skin of the middle finger and index finger.The length of dorsal digital artery was 2.6+0.4 cm and the diameter was 0.2+0.1 mm.Four to 6 micro-cutaneous branches were extended and consistent with the nearby skin cutaneous branches.Conclusion The distal segment of the second dorsal metacarpal artery and the dorsal digital artery is anatomically constant.The distal segment of the second dorsal metacarpal artery and dorsal digital artery are the pedicle for the design of the bilobed flap of middle finger and index finger to repair small soft tissue defect on the thumb and purlicue.