大鱼际皮瓣血管神经解剖研究

目的 为指腹软组织缺损重建感觉功能寻找新的可靠供区。方法 解削11只成人冰冻尸体手,于桡动脉灌注红色乳胶,观察大鱼际皮肤动脉、静脉、神经来源、分支及吻合类型。其中5只手于桡动脉掌浅支分叉处选择性动脉墨汁灌注,测量皮肤染色范围。结果 桡动脉掌浅支分出点平均直径为1.38cm,皮瓣可切取面积平均为3.9cm×3cm,掌浅支于大鱼际肌深筋膜下潜行,固定发出诸多分支到鱼际筋膜及皮肤并相互吻合呈网状。静脉回流有三种途径,神经支配以桡神经浅支和前臂外侧皮神经为主。结论 可设计以桡动脉掌浅支及桡神经浅支或前臂外侧皮神经为蒂的大鱼际游离或逆行岛状皮瓣修复指腹软组织缺损,重建指腹感觉功能。

VASCULAR AND NEURAL ANATOMY OF RADIAL THENAR FLAP

To find a new innervated and vascularized free or islandflap for reconstruction of various skin defects of the volar side of the fingers. Methods 11 fresh cadaver hands were injected with a red dye and dissected to examine the vascular and neural supplies of the radial thener area. In 5 specimens, a selective injection technique was used to determine the extent of skin territory nourished by the superficial palmar branch of the radials artery. Results The average diameter of the branch measured at its bifurcation site was 1.38mm.The average area nourished by the superficial palmar branch was about 3. 9cm** 3.0cm located over the proximal parts of the abductor pollicis brevis and opponens pollicis muscles. Innervation of the flap was provided chiefly by a branch of the superficial radial nerve and the lateral antebrachial cutaneous nerve. Conclusions The radial thenar flap pdicled with superficial palmar branch of the radial artery and a branch of the superficial radial nerve or the lateral antebrachial cuteneous nerve could be designed frce or island - flap transfer for reconstruction of various skkin defects of the palmar side of the fingers.