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目的为游离趾甲皮瓣嵌合第2趾骨复合组织瓣再造拇指术提供解剖学基础。方法10只新鲜成人尸体足标本,经动脉灌注红色乳胶后进行解剖。系统观测趾和第2趾动、静脉分布规律,测量血管长度及直径;模拟游离踇趾甲皮瓣嵌合第2趾骨复合组织瓣再造拇指的术式设计。结果第1跖背动脉在第1趾蹼深层发出2分支:踇趾腓侧趾底固有动脉和第2趾胫侧趾底固有动脉。踇趾腓侧趾底动脉血管(分叉至进入皮瓣)长度(1.82±0.12)cm,直径(1.08±0.06)mm;第2趾胫侧趾底动脉血管(分叉至近侧趾间关节)长度(0.90±0.16)cm,直径(0.82±0.13)mm。静脉分深浅两层,第1、2趾背侧浅静脉汇流入足踝内侧的大隐静脉。模拟再造拇指相互环绕的血管蒂无卡压。结论 趾、第2趾动、静脉血管可保障趾甲皮瓣、第2趾骨复合组织瓣血供,模拟再造拇指相互环绕的血管蒂无卡压;适合设计游离趾甲皮瓣嵌合第2趾骨复合组织瓣再造拇指。
Objective To provide the anatomical basis for the reconstruction of the thumb with the free toenail flap chimeric second metatarsal composite tissue flap. Methods Ten adult fresh adult cadaver specimens were dissected after the artery was infused with red latex. Systemically observe the toe and second toe dynamic and venous distribution of vascular length and diameter measurements; free 踇 toenail flap chimeric second toe composite tissue flap reconstruction thumb surgery design. Results The first dorsal metatarsal artery developed 2 branches in the deep layer of the first toe web: the proper arteries in the aponeurosis and the second toe tibial and posterior vertebra. (1.08 ± 0.06) mm in length, 1.83 ± 0.12 cm in diameter, and 2 toe tibial artery (bifurcation to proximal interphalangeal joint) Length (0.90 ± 0.16) cm, diameter (0.82 ± 0.13) mm. Divided into two layers of deep venous, first toe dorsal superficial vein confluence into the medial saphenous vein. Simulation of recreating the thumb around the vessel pedicle without compression. Conclusions toe, second toe artery and vein can protect toenail flap, blood supply of the second phalanges of composite tissue flap, simulating reconstruction of the blood vessels with thumb around each other without compression, and is suitable for designing the free toenail flap fitting 2 Toe composite tissue flap reconstruction thumb.