Cheng L, Chen K, Chai Y-M, Wen G, Wang C-Y
Department of Orthopedics, Shanghai Sixth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine. Shanghai, China.
J Hand Surg Eur Vol. 2013 Nov;38(9):959-63. doi: 10.1177/1753193413490653. Epub 2013 Jun 3.
We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertip amputations at the eponychial level were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.
为规范门诊指尖再植手术，我们对甲上皮水平的静脉分布进行了一项解剖学研究。通过染料注射后的解剖，研究了100根手指的横断面解剖结构。直径>0.3 mm的静脉分布记录在饼状图上。对27例甲上皮水平指尖离断患者的30根手指进行了掌侧皮下静脉吻合再植，以重建离断指体的静脉回流。解剖学研究辅助了手术操作，并证实掌侧区域是静脉吻合的首选部位。对于甲上皮皱襞水平的手指远端离断，我们建议在3至5点或7至9点位置之间寻找静脉，因为这些区域最有可能存在合适的静脉。
