双轴点掌背皮动脉轴行皮瓣的应用解剖

Applied anatomy of dorsal hand flap with direct cutaneous artery arising from dorsal metacarpal artery as pedicle and double rotation points

目的 :报道手背一种新型皮动脉岛状皮瓣设计的解剖学基础。方法 :对 2 0侧新鲜成人标本 ,在 5倍显微镜下观测掌背血管、肌腱、神经的解剖特点和皮肤的血供。结果 :手掌背皮下组织内存在掌背动脉相平行的皮动脉。第 1掌背动脉出现率为 95 % ,起点外径 ( 0 .8± 0 .1)mm ,长度 ( 7.8± 1.1)cm ,末端外径 ( 0 .4± 0 .2 )mm。第 2掌背动脉出现率为 10 0 % ,起点外径 ( 0 .6± 0 .1)mm ,长度 ( 6.5± 0 .8)cm ,末端外径 ( 0 .4± 0 .1)mm。第 3掌背动脉出现率为 10 0 % ,起点外径 ( 0 .5± 0 .1)mm ,长度 ( 6.5± 0 .7)cm ,末端外径 ( 0 .3± 0 .1)mm。第 4掌背动脉出现率为 90 % ,起点外径 ( 0 .4± 0 .1)mm ,长度 ( 5 .5± 0 .9)cm ,末端外径 ( 0 .3± 0 .1)mm。结论 :掌背皮动脉走行、分支较为恒定 ,可以其为蒂 ,设计双轴点的顺行或逆行岛状皮瓣 ,用于腕、手及手指的软组织缺损的修复。

Objective: To design a new cutaneous artery island flap. Methods: 20 arms of fresh adult cadavers were studied by five-time microscope. Red latex was perfused into the radial artery to show the anatomical characteristics of the dorsal hand tissues on artery, vena, nerve, tendon and the blood supply of the skin. Results: The cutaneous dorsal metacarpal artery paralleled to the dorsal metacarpal artery. It derived from the dorsal vascular network and lined to the dorsal metacarpal artery near the crotch of the digit. The routine and branches were invariableness. Conclusion: The cutaneous dorsal metacarpal artery can be designed as pedicle of the island flap with the double rotation points to repair the soft tissues loss of the wrist, hand and digit.