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目的通过对趾足底动脉和趾底固有动脉的走行规律与不同平面血管外径的显微解剖研究,以及临床应用6类足趾微型组织瓣游离移植修复拇、手指部分缺损,为足趾微型组织瓣移植的血供重建提供指导。方法利用12只新鲜尸体足标本,对第1~4趾足底动脉、第1~4趾趾底固有动脉进行显微解剖、观察、测量分析。临床应用6类足趾微型组织瓣游离移植修复拇、手指部分缺损51例。结果第1~4趾足底动脉由足底深弓发出,起始外径为(1.24±0.36)、(1.16±0.32)、(1.10±0.27)、(1.09±0.29)mm。第1趾腓侧趾底固有动脉起始外径为(1.09±0.21)mm;第2~4趾胫侧趾底固有动脉起始外径为(0.98±0.24)、(0.85±0.18)、(0.82±0.17)mm。临床应用51例足趾微型组织瓣游离移植全部成活,功能恢复均为优,外观优良。结论第1~4趾足底动脉解剖位置与走行恒定。第1趾微型组织瓣的主要供血动脉为腓侧趾底固有动脉,第2~4趾微型组织瓣的主要供血动脉为胫侧趾底固有动脉。
OBJECTIVE: To study the microsurgical anatomy of the artery and toe-descending artery of the toe plantar artery and the different external diameter of planar blood vessels, and to investigate the clinical application of 6 types of toe tissue flap free graft to repair the thumb and finger partial defects. Tissue flap transplantation to provide guidance for the reconstruction of blood. Methods Twelve fresh cadaver specimens were used to dissect, observe and measure the arteries of the first to fourth toe plantar artery and the first to fourth toe cortex. Clinical application of 6 types of toe tissue flap free graft in the repair of thumb and finger partial defect in 51 cases. Results The first to fourth phalanges of the plantar vertebrae were seen from the deep arch of the plantar. The initial diameters were (1.24 ± 0.36), (1.16 ± 0.32), (1.10 ± 0.27) and (1.09 ± 0.29) mm respectively. (1.09 ± 0.21) mm; the initial diameter of the native arteries in the second to fourth tibia (0.98 ± 0.24) and (0.85 ± 0.18), (( 0.82 ± 0.17) mm. 51 cases of clinical application of mini-flap toe all free graft survival, functional recovery are excellent, good appearance. Conclusion The first to fourth toe plantar artery anatomical location and walking constant. The main feeding arteries of the first toe mini-tissue flap are the inherent arteries of the fibular side, and the main feeding arteries of the second to fourth micro-tissue flap are the inherent arteries of the tibial apex.