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目的为改形趾甲皮瓣与第2足趾联合移植再造拇指手术提供解剖学基础。方法对10例20侧红色乳胶灌注的成人足标本(其中新鲜足标本5例10侧)进行显微解剖,观测营养趾甲皮瓣、第2足趾骨皮瓣血供。结果趾甲皮瓣的血供为多源性,主要为趾腓侧趾底动脉和趾趾背动脉,二者外径分别为(1.5±0.3)mm、(0.9±0.2)mm;趾甲皮瓣静脉为大隐静脉-第一跖背静脉-趾腓侧趾背静脉;神经为趾腓侧固有神经和腓深神经。剔除第2足趾甲皮瓣的第2足趾骨皮瓣血供为第2足趾胫侧趾底、趾背动脉,外径分别为(0.7±0.1)mm、(0.3±0.1)mm;静脉为大隐静脉-第一跖背静脉-第2足趾胫侧趾背静脉;神经为第2足趾胫侧趾底固有神经。结论趾腓侧趾底动脉、趾趾背动脉及第2足趾胫侧趾底、趾背动脉起始、走行恒定,外径较粗,有较多皮肤穿支和恒定血供范围,可为改形趾甲皮瓣与第2足趾联合移植再造拇指手术提供理想的血供。
Objective To provide an anatomical basis for the modified thumb 趾 toe flap combined with the second toe transplantation for thumb reconstruction. Methods Ten adult 20-foot red latex infused adult foot specimens (including 5 fresh foot specimens in 5 cases) were dissected microscopically. The nails of the nutrient toenail flap and the blood supply of the second toe flap were observed. Results The blood supply of the toenail flap was multi-sourced, mainly of the dorsal toe pedic artery and otopia dorsal artery. The outer diameter of the flap was (1.5 ± 0.3) mm and (0.9 ± 0.2) mm, respectively Nail flap vein for the great saphenous vein - the first dorsal metatarsal-toe fibular dorsal vein; nerve for the toe fibular side of the nerve and peroneal nerve. The second toe flap flap of the second toenail flap was excluded as the flap of the second tibia at the base of the tibia, the dorsal artery was (0.7 ± 0.1) mm in diameter and (0.3 ± 0.1) mm in diameter. The veins were Great saphenous vein - first dorsal metatarsal vein - second tibiae toe dorsal veins; nerve for the second toe tibial dorsal inherent nerve. CONCLUSIONS: The common toe-to-dorsal artery, the dorsal toe dorsal artery and the second tibialis at the base of the foot and dorsal toe of the second toe begin with a constant course, thicker outer diameter, more skin perforation and constant blood supply, Can provide the ideal blood supply for reformed toenail flap combined with the second toe transplantation for thumb surgery.