摘要
目的分析120例足趾移植再造手指病例,对趾蹼间的血管形态和交通情况进行观察,并阐述其临床意义。方法临床观察120例156侧趾蹼,对第一跖骨背动脉和第一趾底动脉在趾蹼间的走向、口径以及两者的交通支情况进行记录并进行分型。结果按孙博的分型方法[1]Ⅰ型72侧,占46.2%;Ⅱ型57侧,占36.5%;Ⅲ型7侧,占4.5%;Ⅳ型3侧,占1.9%;Ⅴ型15侧,占9.6%;另有2侧(占1.3%)第一跖骨背血管口径>1mm,虽发出趾背动脉供养趾胫侧和第二趾腓侧,但在趾蹼内与趾底血管无吻合,故称之为孙博Ⅵ型。结论(1)从解剖形态看应增加孙博Ⅵ型较全面;(2)从临床实用角度出发,趾蹼间血管可以简单分为三型Ⅰ型交通支口径在0.5mm以上。Ⅱ型交通支在0.5mm以下。Ⅲ型无交通;(3)手术中采用第一套或第二套供血系统,首先要看趾蹼间血管的交通支,即按本组的分型属Ⅰ型采用第一套供血系统,Ⅱ、Ⅲ型采用第二套供血系统。
Objective To observe and classify the vascularity at the toe web and discuss its clinical significance in toe transfer. Methods Vascularity of 156 toe webs in 120 cases of toe transfer was observed. The course, diameter, and communication pattern of the first dorsal metatarsal artery and the first plantar digital artery were recorded. Results According to Sunbo＇ s classification, there were 72 cases of type Ⅰ （46.2 % ）, 57 cases of type Ⅱ （36.5 % ）, 7 cases of type Ⅲ （4.5 % ）, 3 cases of type Ⅳ （ 1.9 % ）, and 15 cases of type Ⅴ （9.6 % ） . 2 cases （ 1.3 % ） could not be counted into any of the above types and were classified as type Ⅵ. In this type the first dorsal metatarsal artery whose diameter was 〉 1 mm and divided into the first dorsalis pedis artery supplying the tibial side of the great toe and the fibular side of the second toe. It did not anastomose with the first plantar digital artery. Conclusions 1. Based on our observation of the vascularity, we add type Ⅵ to Sunbo＇s classification. 2. Clinically this classification can be simplified into three types, type Ⅰ has a communication branch that is 〉 0.Smm in diameter, type Ⅱ has a communication branch that is 〈 0.5mm in diameter, type Ⅲ does not have any anastomosis between the two vessels. 3. Upon our classification we can adopt the blood supply system intra-operatively according to the anastomosis pattern at the toe web, adopting the dorsal blood supply system for type Ⅰ cases and the plantar blood supply system for type Ⅱ and Ⅲ cases.
出处
《中华手外科杂志》
CSCD
北大核心
2006年第1期21-22,共2页
Chinese Journal of Hand Surgery
关键词
趾
血管
组织移植
指损伤
分类法
Toes
Blood vessels
Tissue transplantation
Finger injuries
Classification
