腕部背侧血管蒂骨(膜)瓣的解剖学基础及临床意义  

Anatomical Study and Clinic Significance of Vascularized Bone and Periosteal Flat in Dorsal Wrist

作　　者：张建民[1] 陈振光[1] 张发惠[2] 郑和平[2] 谢日希衷 

机构地区：[1]武汉大学中南医院显微骨科,武汉430071 [2]南京军区福州总医院军区临床解剖学研究中心,福州350025 [3]广东省惠州市中心人民医院骨科,惠州516001

出　　处：《武汉大学学报（医学版）》2003年第4期338-340,349,共4页Medical Journal of Wuhan University

摘　　要：目的 :为腕部背侧带血管蒂骨 (膜 )瓣的设计提供解剖学基础。方法 :30侧经动脉内灌注红色乳胶的成人上肢标本 ,解剖观测了骨间前动脉、桡动脉和尺动脉的腕背支以及第 2 ,3掌背动脉的起始、走行、分支分布及吻合情况。结果 :①骨间前动脉腕背支始于桡骨茎突上 (6 .6± 0 .7)cm处 ,外径 (1.4± 0 .2 )mm ;②桡动脉腕背支起点距桡骨茎突 (1.2± 0 .3)cm ,外径为 (1.3± 0 .3)mm ;③第 2 ,3掌背动脉分别始于桡动脉腕背支和掌深弓的穿支 ,外径均为 (0 .8± 0 .2 )mm ;④尺动脉腕背支于豌豆骨上 (4 .1± 0 .6 )cm始于尺动脉 ,外径 (1.2± 0 .3)mm。上述动脉间相互吻合丰富 ,在手背形成动脉网 ,并发骨膜支分布尺、桡远端和掌骨。结论 :以上述动脉腕背支及第 2 ,3掌背动脉为蒂 ,可以设计不同的带血管蒂的骨 (膜 )瓣 ,用于邻近移位修复舟。Objective: To provide anatomic basis for designs of vascularized bone or periosteal flaps in dorsal wrist. Methods: The origins, courses, branches, distributions and anastomosis of dorsal carpal branch of anterior interosseous artery, radial artery, ulnar artery and second,third dorsal metacarpal arteries were dissected and observed on 30 adult cadaveric upper limber specimens injected with red dye. Results: ① Located(6.6±0.7)cm above styloid process of radius, dorsal carpal branch of anterior interosseous artery was derived from anterior interosseous artery and its diameter was about( 1.4 ±0.2)mm; ② Located (1.2±0.3)cm above styloid process of radius, dorsal carpal branch of radial artery was derived from radial artery and its diameter was about(1.3±0.3)mm; ③ Second,third dorsal metacarpal arteries was derived from dorsal carpal branch of radial artery and perforating branch of deep palmar arch respectively and their diameter was about (0.8±0.2)mm each; ④ Located (4.1±0.6)cm above pisiform bone, dorsal carpal branch of ulnar artery was derived from ulnar artery and its diameter was about (1.2±0.2)mm. The above aforementioned arteries form widespread and constant vessels network in the area of dorsal hand and sent out periosteal branches to nourish metacarpal and proximal end of radius and ulna. Conclusion: Various bone or periosteal flaps pedicled with aforementioned arteries can be designed to transposed nearly to repair nonunion or necrosis of scaphoid and lunate bone.

关 键 词：腕部背侧血管蒂骨瓣 解剖学基础 腕部背侧血管蒂膜瓣 骨不连 

分 类 号：R683.41[医药卫生—骨科学]