以第1跖背动脉为蒂的足背皮瓣血供范围的解剖学研究

发布时间：2019-02-26 11:22

【摘要】：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。
[Abstract]:Objective to explore the blood supply range of dorsum pedis flap pedicled with the first dorsal metatarsal artery in order to provide a theoretical basis for the transplantation of the second toe with the first dorsal metatarsal artery as the pedicle of the first dorsal metatarsal artery. Methods Ten fresh amputation unilateral specimens were dissected and perfused with ink from the first dorsal metatarsal artery. Then the skin flap was lifted from the deep fascia under microscope to observe the staining range of small skin branches. In addition, 3 sides of the specimens were taken to make the cast specimens of blood vessels. The measured results were statistically processed. Results (1) ink perfusion staining: the staining range of 10 specimens was as follows: medial border to tibialis of toe, lateral margin to third web space, distal boundary to toe end. The proximal border reached the tarsometatarsal joint. (2) observation on cast specimens: the branches of the first and second proximal toe arteries were densely distributed, and the communicating branches between the dorsal metatarsal arteries were found in the first, second and third dorsal metatarsal arteries. Conclusion (1) the dorsal pedis flap pedicled with the first dorsal metatarsal artery is rich in blood supply to the tibial side, and the fibular blood supply can reach the fibular side of the third toe web. (2) when designing the dorsal pedal flap with rhomboid or rudder shape, the sural flap should not be too large in clinical design.
【作者单位】：潍坊市益都中心医院骨科;青州市中医院肿瘤科;解放军第401医院全军手外科中心;
【分类号】：R322

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