第二跗跖部分关节移植重建拇腕掌关节的应用解剖

目的 为第二跗跖部分关节移植重建拇腕掌关节提供解剖学基础。方法 30侧红色乳胶灌注的成人下肢标本，解剖观测第二跗跖关节背侧血供起源、走行、分支分布及吻合。结果 第二跗跖关节有明显的多源性供血特点，其背侧血供源于以下动脉：足背动脉2～6支，第一跖背动脉1～3支，第二跖背动脉3～6支，弓状动脉3～7支，跗外侧动脉2～5支。上述动脉的骨膜支外径在0．1～1.0mm之间，在第二跗跖关节周围吻合成骨膜动脉网。结论 吻合血管的第二跗跖部分关节移植的设计具有可行性，依据血管的分布规律，可设计4种不同血管蒂的第二跗跖部分关节移植，用于重建拇腕掌关节。

Applied anatomy of reconstruction of carpometacarpal joint of thumb by second tarsometatarsal demijoint graft

Objective To provide anatomic basis for reconstruction of carpometacarpal joint of thumb by second tarsometatarsal demi-joint graft. Methods The origin, course, distribution and anastomosis of dorsal blood supply were observed and measured in 30 adult cadaveric limbs perfused with red latex. Results The second tarsometatarsal joint had obvious feature of multi-source blood supply, its dorsal blood supply originated from following arteries: 2~6 branches of dorsal artery of foot, 1~3 branches of first dorsal metatarsal artery, 3~6 branches of second dorsal metatarsal artery, 3~7 branches of arcuate artery, 2~5 branches of lateral tarsal artery, and their diameter were 0.1~1.0 mm. Periosteal branches of above mentioned arteries formed arterial rete around second tarsometatarsal joint. Conclusion The design of vascularized second tarsometatarsal demi-joint graft is feasible, and according to the distribution rule, the second tarsometatarsal demi-joint designed with types of different vessel pedicles could be transplanted to reconstruct the carpometacarpal joint of thumb.