Free neurovascular flap from the first web of the foot in hand reconstruction.
Free neurovascular flap from the first web of the foot in hand reconstruction.
复制标题
手部重建中从第一足蹼游离神经血管瓣。
DOI：
10.1097/00006534-197809000-00091
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发表时间：
1978
期刊：
影响因子：
--
通讯作者：
B. O'brien
中科院分区：
文献类型：
--
作者：
J. May;L. Chait;B. Cohen;B. O'brien
为寻找一种解剖可靠、功能可接受的神经血管游离皮瓣用于手再造，在手术显微镜下解剖了50例新鲜尸体足，特别注意第一蹼区的解剖。远端交通动脉在100%的夹层中可见，允许背侧或足底供体动脉流入以滋养整个皮瓣区域。由于易于分离，建议将第一跖骨背或足背动脉作为供体动脉，并建议将大隐静脉系统的背侧分支作为供体静脉。腓深神经被认为是一致的神经支配的第一个网站，并沿着与足底趾神经，建议作为解剖学上可识别的供体神经。脚第一网的任一部分可以单独使用或一起用作自由翼片。当需要时，可将更多的背侧皮肤结合到蹼皮瓣中以扩大其应用。在50个正常人的拇趾足底外侧表面的两点歧视的研究显示，平均为11.2毫米。这是一个潜在的供体皮瓣比内侧背的脚，平均为32毫米。一个单一的情况下，展示了这种皮瓣在手重建的应用。
To identify an anatomically reliable and functionally acceptable neurovascular free flap for use in hand reconstruction, 50 fresh cadaver feet were dissected under the operating microscope, with particular attention paid to the anatomy of the first web area. A distal communicating artery was seen in 100% of dissections, allowing either dorsal or plantar donor artery inflow to nourish the entire flap area. Because of the ease of dissection, the first dorsal metatarsal or dorsalis pedis is suggested as the donor artery, and a dorsal branch of the greater saphenous venous system is suggested as the donor vein. The deep peroneal nerve was seen to consistently innervate the first web and, along with the plantar digital nerves, is suggested as an anatomically identifiable donor nerve. Either part of the foot first web may be used alone or together as a free flap. When indicated further dorsal skin may be incorporated into the web flap to expand its application. Two-point discrimination studies of the lateral plantar surface of the great toe in 50 normal individuals showed an average of 11.2 mm. This was significantly better as a potential donor flap than the medial dorsum of the foot where the average was 32 mm. A single case demonstrating the application of this flap in hand reconstruction is presented.