以尺动脉腕背支为蒂双叶骨皮瓣再造拇指的应用解剖

Applied anatomy of reconstruction thumb of free bifoltaed bone flap pedicled with the dorsal carpal branch of ulnar artery

目的 为应用尺动脉腕背支骨皮瓣再造拇指提供解剖学理论基础。 方法 3 5侧经动脉内灌注红色乳胶的成人上肢标本 ,解剖观测尺动脉腕背支的起源、走行、分支、外径、皮支及骨膜支 ,用一侧标本进行再造拇指摹拟手术实验。 结果 腕背支于豌豆骨上 (4 0± 1 0 )cm始于尺动脉 ,干长 (1 2± 0 5 )cm ,外径 (1 3± 0 5 )mm。分出升支和降支 ,外径分别为 (0 8± 0 3 )mm和 (1 1± 0 2 )mm。腕背支的皮支分布前臂尺侧、腕部和手背尺侧 ,骨膜支分布尺骨远段前内侧面和第 5掌骨。 结论 尺动脉腕背支为蒂的前臂尺侧和手背尺侧双叶骨皮瓣 ,可用于再造拇指。

Objective To provide anatomical basis for reconstruction thumb of free bifoltaed bone flap pedicled with the dorsal carpal branch of ulnar artery. Methods After red latex was infused into the arteries of 35 sides of adult cadaveric upper limbs, the origin, course, branches, diameters, skin branches and periosteal branches of dorsal carpal branch of ulnar artery were observed, to initate operation experiment of reconstruction thumb on 1 sides. Results The dorsal carpal branch begins with ulnar artery (4.0±1.0)cm above the pisiform with diameter of (1.3±0.5)mm, its pedicle ranges(1.2±0.5)cm and branches off into ascending and descending branches. There were outer diameter range(0.8±0.3)mm and (1.1±0.2)mm. Skin branches of dorsal carpal branch of ulnar artery nourinshed the forearm ulnar side, carpal and dorso-ulnar aspect of mid-hand, periosteal branches of dorsal carpal branch of ulnar artery nourished the anterior internus side of the ulnar and the fifth metacarpal bone. Conclusion The free bifoltaed bone flap pedicled with the dorsal carpal branch of ulnar artery is available to reconstruction the thumb.