摘要
目的报告大鱼际桡侧皮瓣的显微外科解剖学基础,设计一种修复拇指指腹缺损的新皮瓣。方法选用成人尸体上肢30只,红色乳胶灌注,解剖观察大鱼际区皮肤的血管和神经来源、分支及吻合情况。结果所有标本均发现有拇指桡侧指动脉恒定存在。其中直接来源于桡动脉掌浅支或掌浅弓者有4例,占13.33%（4/30）。此时拇指桡侧指动脉全程走行于大鱼际肌的浅面,发出5~9个皮支营养整个大鱼际皮肤。来源于拇主要动脉者有26例,占86.67%（26/30）。拇指桡侧指动脉穿过大鱼际肌后,立即向内上方发出一粗大返支。这一返支发出2~7支皮支营养大鱼际远端2/3的皮肤,并向近端与来源于桡动脉掌浅支的皮支交通呈网状联系。结论拇指桡侧指动脉是大鱼际区皮肤的主要营养血管,可以设计以拇指桡侧指动脉为蒂的大鱼际桡侧皮瓣修复修复拇指指腹缺损。
Objective To report microsurgical anatomy basis for design a new flap to repair soft tissue defect of the volar side of the thumb.Methods 30 fresh cadavers were injected with a silicone rubber compound and dissected to examine the vascular and neural supplies of the thenar area.Results The thumb lateral digital artery（TLDA） was found in all hands.In 13.33（4/30）percent of the hands dissected,the TLDA was originated from the surperficial branch of the radial artery or the superficial palmar arch,and run distally above the thenar muscles giving off 5～9 perforating branches to the radial thenar fasciocutaneous area.In86.67（26/30） percent of the specimens,the TLDA was originated from the thumb major artery.After the TLDA run through the thumb muscle,it immediately gave off 2～7 reverse branchs nurishing the distal 2/3 part of the radial thenar fasciocutaneous area.Microvascular connections between this reverse branch and the surperficial branch of the radial artery were observed in all the cases.Conclusion The TLDA is the main vascular supply of the radial thenar area.A reversed radial thenar island flap pedicled with the TLDA can be designed to repair soft tissue defect of the volar side of the thumb.
出处
《中国实用医药》
2011年第5期23-24,共2页
China Practical Medicine
