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目的探讨足底外侧动脉第5跖骨穿支形态学特征,为前足软组织缺损修复提新术式。方法在30侧动脉内灌注红色乳胶的成人足标本上,以第5跖骨粗隆为观测标志,手术放大镜下重点解剖观测:1足底外侧动脉第5跖骨穿支起源、走行、分支及分布;2第5跖骨穿支与足背外侧区血管吻合特点。另1侧新鲜标本摹拟手术设计。结果 1第5跖骨穿支为足底外侧动脉在第5跖骨粗隆平面恒定的分支,有第5跖骨底和跖骨头二穿支,外行于第5跖骨内缘,分别自第5跖骨体两端(底体移行处和跖骨颈)与小趾外侧群肌(小趾展肌、小趾短屈肌)之间浅出至足背外缘,并与足背外侧区的跗外侧动脉、第4跖背动脉相吻合,沿途分出细小血管营养临近组织;2跖骨底和跖骨头穿支起始外径分别为(1.3±0.2)和(0.9±0.3)mm、主干分别为(2.6±0.3)cm和(3.8±0.5)cm。结论足底外侧动脉第5跖骨穿支解剖恒定,临床根据需要可酌情选择任一种穿支为蒂设计皮瓣修复前足软组织缺损。
Objective To investigate the morphological features of the fifth metatarsal perforation of the plantar lateral artery and to provide a new surgical technique for the repair of forefoot soft tissue defects. Methods The third metatarsal tuberosity was taken as an observation sign on 30 adult patients with red latex injected into the artery. The anatomy was observed under a magnifying glass under the magnifying glass. The origin, course, branch and distribution of the fifth metatarsal perforator of the lateral plantar artery were observed. 2 5th metatarsal perforation and dorsolateral vascular anastomosis characteristics. The other side of fresh specimens simulated surgical design. Results The fifth metatarsal perforation was the constant branch of the lateral plantar artery in the fifth metatarsal tuberosity. The fifth metatarsal base and the second metatarsal head penetrated the medial margin of the fifth metatarsal. (Basilar transitional and metatarsal neck) and the little toe lateral group muscle (small toe extensor, short toe flexor) shallow to the outer edge of the dorsal foot, and dorsal lateral pterygoid artery, the first 4 metatarsal dorsal artery anastomosis, along the way out of fine vascular nutrition adjacent to the organization; 2 metatarsal and metatarsal head perforating branch initial diameter were (1.3 ± 0.2) and (0.9 ± 0.3) mm, respectively, the main trunk were (2.6 ± 0.3 ) cm and (3.8 ± 0.5) cm. Conclusions The fifth metatarsal perforator of the lateral plantar artery is anatomically constant. According to the needs of clinical practice, either the perforator pedicle design flaps can be used to repair the forefoot soft tissue defect.