小指尺掌侧动脉穿支皮瓣的解剖学基础  

Anatomical basis of the perforator flap from the ulnar palmar digital artery of the little finger

作　　者：郝攀登[1] 郑和平[1] 林涧[2] 张发惠[1] 

机构地区：[1]福建医科大学福总临床医学院(南京军区福州总医院)骨科研究所,福州350025 [2]浙江省台州市博爱医院显微外科

出　　处：《中华显微外科杂志》2013年第1期56-59,共4页Chinese Journal of Microsurgery

基　　金：福建省自然科学基金资助项目（2012J01410）

摘　　要：目的探讨小指尺掌侧动脉穿支和尺动脉腕上皮支降支的解剖学特征，为临床尺侧手掌及小指软组织缺损的重建提供新术式。方法选用30侧经动脉内灌注红色乳胶的成人上肢标本，以第5掌骨头为观测标志点，手术放大镜下重点解剖观测：①小指尺掌侧动脉穿支的起源、外径、分支与分布、主干长度及主干到第五掌骨头的最短距离；②尺动脉腕上皮支降支的走行及分布。另选1侧新鲜标本进行摹拟手术设计。结果小指尺掌侧动脉93．3％起自掌浅弓凸侧的尺侧缘，6．7％由第3掌心动脉与掌深弓发出的分支汇合而成。不同起源的小指尺掌侧动脉发出的穿支穿出深筋膜位置相对恒定，穿出点位于第五掌骨头上（1．3±0．3）cm处，由小鱼际浅层肌（小指短屈肌与小指展肌）与第五掌骨之间穿出至皮下，与尺动脉腕上皮支降支形成直接或间接吻合。小指尺掌侧动脉穿支起始外径（0．8±0．4）mm，穿支动脉干长（2．0±0．6）cm。结论小指尺掌侧动脉穿支与尺动脉腕上皮支吻合点位置较固定。以小指尺掌侧动脉穿支为蒂设计皮瓣，血供可靠，转位灵活，可用于修复尺侧手掌及小指软组织缺损。Objective Through investigating the anatomical features of the perforator from the ulnar palmar digital artery of the little finger and the dorsal descending branch of the ulnar artery, to establish a new approach for the reconstruction of soft tissue defect of the ulnar palm and the little finger. Methods The fifth caput metacarpale was taken as the observation points on 30 specimens of adult human upper limb perfused with red latex. Something as follows were observed under surgery magnifier： ①The origin, external diameter, bran- ches, distribution and the backbone length of the perforator of the ulnar palmar digital artery of the little finger; the distance from the fifth caput metacarpale to the perforate artery ; ②The route and distribution of the dorsal descending branch of the ulnar artery . Mimic operation was performed on another fresh specimen. Results The origin of the ulnar palmar digital artery of the little finger has two different type ： 93.3% spring from the ex- ternal of the arcus volaris superfieialis, 6. 7% formed by the combination of the third arteriae metacarpeae pal- mares and the branch from areus volaris profundus. Ahhough it has two different origins, the perforator has only one piercing point, which located at （ 1.3±0. 3 ） cm upon the fifth caput metacarpale. The perforator , ultimate- ly, combines with the descending branch of the ulnar artery after it pass through the slot between the muscle ten- don of hypothenar superficial layer （ the flexor digiti minimi brevis and the abductor digiti minimi ） and the fifth metacarpale bone. External diameter of the perforator was （0. 8 ± 0. 4） mm and the backbone length was （ 2. 0 ± 0. 6）cm. Conclusion The location of the anastomose point between the perforator, which springs from the ulnar palmar digital artery of the little finger , and the dorsal descending branch of the ulnar artery is constant. The perforator flap based on the perforator of ulnar palmar digital artery of the little finger, with sufficient blood supp

关 键 词：小指尺掌侧动脉 尺动脉腕上皮支 穿支皮瓣 应用解剖 

分 类 号：R65[医药卫生—外科学] R3[医药卫生—临床医学]