以拇指桡侧筋膜血管为蒂第1掌骨背侧皮瓣的应用解剖  

Applied anatomy of the first metacarpal dorsal flap pedicled with the radial pollical vessels and fascia

作　　者：周吉林[1,2,3] 何葆华[1,2,3] 宋建良 吴卫华[1,2,3] 严晟 朱云山[1,2,3] 林向进 朱[1,2,3] 任国良 郑荣昌[1,2,3] 

机构地区：[1]浙江医科大学解剖学教研室 [2]杭州整形医院 [3]浙江医科大学附属第一医院骨科

出　　处：《中国临床解剖学杂志》1999年第3期232-233,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的：为以拇指桡掌侧动脉掌指关节周围分支为蒂的第１掌骨背侧皮瓣提供解剖学基础。方法：新鲜尸体手标本３２个，分别进行血管染料灌注、血管造影、透明标本、显微解剖观察。结果：①拇指桡掌侧动脉掌指关节周围分支在第１掌指关节桡背侧与拇指桡侧指背动脉吻合，并在第１掌骨背侧区域形成筋膜、皮下血管网；②第１掌骨背侧有２条同行浅静脉干，其位于拇短伸指肌腱两侧，并存在静脉瓣膜。结论：以拇指桡掌侧动脉第１掌指关节周围支为主要血供来源，经拇指背静脉交通至头静脉为主要回流途径的血管筋膜蒂皮瓣，血供可靠、切取方便、供区创伤较小，临床上可用于修复拇、示、中、环指皮肤软组织缺损。Objective: To study the arterial branches of the radial palmar pollicol artery (RPPA) at the first metacarpophalangeal joint, the radial dosrsal pollical artery (RDPA) and the dorsal pollical venous refluence, and design a first metacarpal dorsal flap pedicled with RPPA at the first metacarpophalangeal joint. Methods:Thirty two fresh hand specimens wers studied with vascular infusion of dyes, X ray radiography, transparency and microscopic surgery dissection.Results:At the first metacarpophalangeal joint, anastomosis between the branches of the RPPA and RDPA formed a fascial and subcutaneous vacular network at the back of the first metacarpal bone.Two veins on both sides of the tendon of the short extensor muscle of thumb with venous valves could be found.Conclusions:This first metacarpal dorsal flap could be supplied by the branches of RPPA, drained from the dorsal pollical veins to the venae cephalic.It processed the advantages of reliable blood supply, easily harvest with little damage on the donor, and could be used to repair the skin defects in the ring finger, middle finger, index finger and thumb.

关 键 词：第1掌骨 外科皮瓣 应用解剖 

分 类 号：R602[医药卫生—外科学]