大鱼际皮瓣的显微解剖及其临床应用  

Micro-anatomical study and clinical application of the thenar flap

作　　者：李锦荣 李浪 许亚军[2] 张健荣 赵善明 卢尔海 赵双奇 

机构地区：[1]新会人民医院显微手外科,广东江门529100 [2]无锡市手外科医院,江苏无锡214062

出　　处：《中国临床解剖学杂志》2004年第4期444-445,448,共3页Chinese Journal of Clinical Anatomy

基　　金：广东省卫生厅医学科研课题(A2002809)

摘　　要：目的:报道大鱼际皮瓣的显微外科解剖学基础及游离移植修复指腹缺损的方法。方法:10例新鲜废弃手标本,在远侧腕横纹上方5～6cm处解剖出桡动脉,向其远端灌注红色乳胶,在手术显微镜下进行解剖,观察皮瓣供区血管神经走行、分布及吻合情况,确定该皮瓣设计切取的“点、线、面”,游离移植修复指腹缺损7例。结果:10例标本及7例病人中,除1例标本外,余均有桡动脉掌浅支存在。其起点处的直径1.2～1.4mm,长度1.5～2.5cm,皮瓣面积约3cm×5cm。7例游离皮瓣全部成活,术后随访6～12个月,手外形及功能满意。结论:(1)、大鱼际皮瓣血管蒂的长度、口径适合显微外科的吻合要求,可用于游离移植;(2)、皮瓣结构、血管口径与指部相当,是修复指腹软组织缺损的较理想方法。To study the microsurgery anatomical basis of the thenar flap and provide method for repairing ventral soft tissue defect of the finger through free transplantation of the flap, Methods: Ten fresh abandoned hands were selected to dissect radial arteries above the distal wrist strip 5～6cm and perfuse with red latex. The origins, distributions and anastomosis of the blood vessels and nerves were observed under the operative microscope, while the 'point, line and surface' of the designed flap were determined. The flaps were free transplanted to repair ventral defect of the finger in seven cases. Results: Superficial palmar branch of radial artery presented in all specimens and patients except one specimen. The diameter of their starting point was about 1.2～1.4 mm, the length 1.5～2.5 cm. The area of the flaps was about 3cm×5 cm. 7 case free flaps survived. Followed up 6～12 months after operation, the appearance and function of the hands recovered well. Conclusions: (1) The length and caliber of the vessel pedicel of the thenar flap fit the demand ofmicrosugical anastomosis and can be applied in free transplantation. (2) The flap's construction and vessel caliber is similar to the finger and suitable for repairing ventral detect of the finger.

关 键 词：大鱼际 皮瓣 显微解剖 游离移植 

分 类 号：R616.2[医药卫生—外科学] R323.71[医药卫生—临床医学]