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目的通过墨汁灌注及血管铸形标本的制作,从解剖学探讨以第1跖背动脉为蒂的足背皮瓣的血供范围,为临床以第1跖背动脉为蒂的带足背皮瓣的第2足趾移植提供理论依据。方法将10侧新鲜截肢单足标本解剖分离后,从第1跖背动脉灌注墨汁,观测其染色范围。然后在显微镜下将皮瓣从深筋膜下掀起,观察细小皮支的染色范围。另取3侧标本,制作血管铸型标本。对测量结果进行统计学处理。结果 (1)墨汁灌注染色:10侧标本染色范围为:内侧界达趾胫侧,外侧界达第3趾蹼间隙,远侧界达趾端,近侧界达跖跗关节。(2)铸型标本观察:第1、2趾近端动脉分支分布密集,并可见第1、2、3跖背动脉之间的交通支。结论 (1)以第1跖背动脉为蒂的足背皮瓣胫侧血供丰富,腓侧血供范围可达第3趾蹼腓侧。(2)在临床上设计带菱形或舵样足背皮瓣时,腓侧皮瓣不宜设计过大。
Objective To study the blood supply of the dorsalis pedis pedicel pedicled with the first plantar dorsal artery from the anatomy of ink perfusion and blood vessel casting specimens. The second toe transplantation provides a theoretical basis. Methods Ten fresh amputated single foot specimens were dissected and the ink was infused from the first plantar dorsal artery to observe the staining range. The flap was then lifted under a deep fascia under a microscope to observe the extent of staining of the small skin branch. Another 3 side specimens, the production of vascular cast specimens. The measurement results were statistically processed. Results (1) Ink perfusion staining: The staining range of 10 specimens was: the medial border reaching the tibia, the lateral boundary reached the third toe web gap, the distal boundary reached the toe end, and the proximal boundary reached the tarsometatarsal joint. (2) Observation of the cast specimens: The branches of the proximal and distal arterial branches of the first and second toes are densely distributed, and the traffic branch between the first and second caudal arteries can be seen. Conclusions (1) The dorsalis pedis pedicle flap pedicled with the first dorsal metatarsal artery is rich in blood supply, and the blood supply range of the fibular side can reach the fibular side of the third toe fins. (2) In clinical design with rhomboid or rudder-like dorsal skin flap, the flaps should not be too large.