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目的 :为带血管蒂的第 5腕掌关节移位修复和重建手的功能性关节提供解剖学基础。方法 :2 2侧冷冻成人上肢标本 ,显微解剖观测第 5腕掌关节的结构特点、关节面的形状、血供来源、神经支配、韧带的构成及长、宽、厚度 ,并测量关节的活动度。模拟设计以腕背动脉网及其分支为蒂的第五腕掌关节移位术。结果 :①第 5腕掌关节为鞍状关节 ,具有屈伸 3 9.16°± 4.2 4°的活动范围。②第 5腕掌关节的血供来自掌深弓尺侧返支、第 4掌背动脉近端的关节支和尺动脉手背支、腕掌网和腕背网的分支。③第 5腕掌关节由尺神经支配 ,掌侧为尺神经深支的分支 ,背侧为尺神经手背支分支。结论 :可设计以掌背血管筋膜为蒂的逆行和以桡动脉腕背支筋膜为蒂的顺行第 5腕掌关节移位 ,用于修复和重建拇指腕掌关节和第 2～ 5掌指关节
OBJECTIVE: To provide an anatomical basis for the displacement of the fifth carpometacarpal joint with vascular pedicle to repair and reconstruct the functional joints of the hand. METHODS: The adult upper limbs were cryopreserved on 2 2 sides. The anatomic features of the 5th wrist, the shape of the articular surface, the source of blood supply, the innervation of the nerve, the composition of the ligaments and the length, width and thickness of the articular surface were measured microscopically. degree. The fifth wrist metacarpopular displacement was modeled as a wrist carpal artery network and its branches. Results: The fifth carpometacarpal joint was a saddle joint with the range of motion of 3 9.16 ° ± 4.2 4 ° flexion and extension. The blood supply from the 5th wrist metatarsal branch from the ulnar side of the dorsal metacarpal and the branch of the dorsal ramus of the 4th dorsalis pedis artery and the dorsal ramus of the ulnar artery. The fifth wrist metatarsal ulnar nerve dominated by the palm side of the ulnar nerve branches, dorsal ulnar nerve dorsal branch. CONCLUSIONS: The retrograde pedicled pedicled vascular fascia can be designed to retrograde and the fifth parafolocephalic wrist with pedicled radial wrist dorsal fascia can be used to repair and reconstruct the wrist and the second to fifth Finger joints