以第1跖背动脉为蒂的足背皮瓣血供范围的解剖学研究

目的　通过墨汁灌注及血管铸形标本的制作，从解剖学探讨以第1跖背动脉为蒂的足背皮瓣的血供范围，为临床以第1跖背动脉为蒂的带足背皮瓣的第2足趾移植提供理论依据。 方法　将10侧新鲜截肢单足标本解剖分离后，从第1跖背动脉灌注墨汁，观测其染色范围。然后在显微镜下将皮瓣从深筋膜下掀起，观察细小皮支的染色范围。另取3侧标本，制作血管铸型标本。对测量结果进行统计学处理。 结果　(1)墨汁灌注染色：10侧标本染色范围为：内侧界达趾胫侧,外侧界达第3趾蹼间隙,远侧界达趾端,近侧界达跖跗关节。 (2)铸型标本观察：第1、2趾近端动脉分支分布密集，并可见第1、2、3跖背动脉之间的交通支。 结论　(1)以第1跖背动脉为蒂的足背皮瓣胫侧血供丰富，腓侧血供范围可达第3趾蹼腓侧。(2)在临床上设计带菱形或舵样足背皮瓣时，腓侧皮瓣不宜设计过大。

The anatomical study of of the vascularized territory of the dorsalis pedis flap pedicled with the first dorsal metatarsal artery

Objective　To study the vascularized territory of the dorsalis pedis flap pedicled with the first dorsal metatarsal artery in anatomy by infusing ink in the amputated foot specimens, providng anatomical evidence for second toe transfer with the dorsalis pedis flap.　Method　After separating the ten feet from the newly dead adults, ink was injected into the feet through the first dorsal metatarsal artery to measure the dosral area being dyed.. Furthermore, dorsalis pedis flaps were elevated to observe and measure the area of the subdermal vascular plexus being dyed. We take another three feet and pour the green ethylene perchloride into the first dorsal metatarsal artery and corrode the foot with the solution of the sodium hydroxide. Then we get the casting mould.　Result　(1) Ink dyeing: The dyeing scope of the ten specimens: The medial boundary line of the flap is the tibial border of the big toe. The lateral boundary of the flap is the territory of the third toe web. The distal boundary line of the flap can reach the first to the third toe. The proximal boundary line of the flap is the proximal part of the tarsometatarsal joints. (2) Cast mould specimen: the first and the second toe is dyed evidently. We can see small subcutaneous branches from the first to the second toe.　Conclusion　Blood supply of the tibial part of the flap is good. The reliable fibular boundary line of the flap is the third toe web. When we design the dorsalis pedis flap , we should design the flap towards the tibial side for enough blood supply.