第1骨间背侧肌支神经肌蒂转移修复拇对掌肌功能应用解剖  

Neuromuscular pedicle of the first dorsal interosseous muscle branch transfer to renovate opponens pollicis:an applied anatomy study

作　　者：侯致典[1] 王增涛[2] 陶文强[1] 李向明[1] 章明星[1] 周星星[1] 丁自海[1] 

机构地区：[1]南方医科大学微创外科解剖学研究所、广东省创伤救治科研中心,广州510515 [2]山东省立医院手足外科,济南250021

出　　处：《中国临床解剖学杂志》2010年第2期135-137,141,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省科技厅重大专项基金(2006A36001003);广东省重大科技工程(2007AZ1-E0081)

摘　　要：目的探讨带血供的尺神经深支第1骨间背侧肌支神经肌蒂转移修复拇对掌肌功能术式的可行性,为临床应用提供解剖学基础。方法新鲜和固定上肢标本各10例,在手术显微镜下解剖观测尺神经第1骨间背侧肌支及其营养血管的分支、分布情况,据此设计带血管的第1骨间背侧肌支神经肌蒂转移修复拇对掌肌功能的手术方式。结果尺神经深支第1骨间背侧肌支进入肌肉前分出2个分支,分别由肌肉的上下1/3处进入肌肉;远端肌支横径(1.5±0.2)mm,可无损伤分离长度为(2.8±0.3)cm,足够到达受区,其营养血管发自第1或第2掌心动脉,起始处直径为(0.8±0.3)mm。结论带血供的尺神经第1骨间背侧肌支神经肌蒂转移修复拇指对掌肌功能的术式具有可行性,该术式实用性、有效性有待临床进一步验证。Objective To provide anatomical basis for neuromuscular pedicle of the first dorsal interosseous muscle branch with blood supply transposition to renovate opponens pollicis. Methods Twenty cadaveric upper extremities （10 of formalin fixation,and 10 of fresh）were dissected. The course,diamaeter,interfascicular dissectible length of the first dorsal interosseous muscle branch were investigated under operating microscope respectively. And then,the operational approach of using neuromuscular pedicle of the first dorsal interosseous muscle branch with blood supply to renovate the opponens pollicis were designed and executed. Results The first dorsal interosseous muscle branch of the deep branch of ulnar nerve gave off two branches. Each of them entered into the upper or lower 1/3 segment of the muscle. The diameter of the distal branch was about （1.5±0.2） mm. The uninjured dissectible length of it was （2.8±0.3）cm,which was the suitable length to reach the recipient area. The diameter of artery supplied the never branch was about （0.8 ±0.3） mm. Conclusions It is feasible to renovate the opponens pollicis by transferring neuromuscular pedicle of the first dorsal interosseous muscle branch with blood supply to the defects. The new neuromuscular pedicle transfer procedure provides an option for the restoration of the opponens pollicis function.

关 键 词：神经肌蒂 尺神经 拇对掌肌 应用解剖 

分 类 号：R622[医药卫生—整形外科]