第二趾趾端弓上动脉岛状皮瓣塑形再造手指的可行性研究  

Feasibility study on toetip arch artery island flap of the second toe in the reconstruction of finger

作　　者：唐林峰[1] 巨积辉[1] 金光哲[1] 张广亮[1] 刘杰 侯瑞兴[1] TANG Lin-feng;JU Ji-hui;JIN Guang-zhe;ZHANG Guang-liang;LIU Jie;HOU Rui-xing(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Suzhou 215104,China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《中国美容整形外科杂志》2020年第7期393-395,404,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：江苏省青年医学重点人才项目(QNRC2016221);苏州市应用基础研究计划项目(SYS201503);苏州市科教兴卫计划项目(KJXW2014056)。

摘　　要：目的探讨第二趾趾端弓上动脉岛状皮瓣的设计方法及其塑形再造手指的可行性。方法经足背动脉或胫后动脉灌注10只新鲜成人足部标本,自跖趾关节处离断第二趾。根据第二趾趾端弓上动脉的解剖学特点,在新鲜标本上标记第二趾趾端弓上动脉的体表投影,确定趾端弓上动脉岛状皮瓣的设计位置。根据新鲜标本第二趾趾腹膨大处的周径、颈部狭窄处的周径及狭窄处的长度,计算出趾端弓上动脉岛状皮瓣的面积。沿皮瓣设计线切开,将趾端弓上动脉岛状皮瓣带蒂转移至颈部狭窄处,与术前外形对比。结果第二趾趾端弓上动脉岛状皮瓣的设计、切取及移植均顺利完成。根据趾端弓上动脉的走行特点及第二趾趾腹膨大的位置,可确定皮瓣的设计方法;根据第二趾周径的测量,可确定该皮瓣的设计面积;根据新鲜标本的模拟切取,可确定该皮瓣的模拟手术方法。结论采用趾端弓上动脉岛状皮瓣可改善足第二趾外形,具有血供可靠、旋转不受限制的特点,并可以获得较满意的疗效。临床工作中采用该皮瓣重塑再造指外形是可行的。Objective To explore the design method and feasibility of toetip arch artery island flap of the second toe in the reconstruction of finger.Methods Ten fresh adult foot specimens were selected and the red latex was perfused from the dorsal artery of foot or posterior tibial artery.The second toe was severed from themetatarsophalangeal joint.According to the anatomical characteristics of toetip arch artery of the second toe,the surface projection of toetip arch artery of the second toe was marked on the resh specimens and the design position of the toetip arch artery island flap was determined.According to the circumference of the second toe pulp enlargement,"neck"stenosis of the toe and the length of stenosis in the fresh specimens,the area of toetip arch artery island flap was calculated.The incision was made along the design line of the flap,the pedicle toetip arch artery island flap was transferred to the"neck"stenosis of the toe.The preoperative and postoperative appearance was compared.Results The design,harvest and transplantation of the toetip arch artery island flap of the second toe were successfully completed.The design method of the flap could be determined according to the distribution characteristics of toetip arch artery and the position of second toe pulp enlargement.The design area of the flap could be determined according to the circumference measurement of the second toe.The simulated operation method could be determined according to the simulated harvest of fresh specimens.Conclusion The application of toetip arch artery island flap in the improvement of the second toe appearance was characterized by reliable blood supply and unrestricted rotation.The satisfactory efficacy could be obtained.It is feasible to reconstruct the finger with toetip arch artery island flap in clinic.

关 键 词：手指再造 解剖学 弓上动脉 岛状皮瓣 整形修复 

分 类 号：R658.1[医药卫生—外科学]