Lohasammakul Suphalerk, Turbpaiboon Chairat, Chaiyasate Kongkrit, Tatsanavivat Parin, Chompoopong Supin, Roham Ali, Ratanalekha Rosarin, Aojanepong Chongdee
Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Microsurgery. 2018 Jul;38(5):536-543. doi: 10.1002/micr.30321. Epub 2018 Mar 25.
Medial plantar artery perforator (MPAP) flap was proposed as proper option for finger pulp reconstruction. To provide the previously unavailable vessel information required for this small flap design, this study aimed to gather all necessary anatomy of MPA, MPAP, and their territories of blood supply to apply in clinical MPAP flap reconstruction minimizing perforator injury.
Dissection of 30 Thai cadaveric feet for visualizing superficial branch of MPA and its perforators (MPAP) using acrylic dye cannulation were performed. Diameter, length, number of branches, course, distributing areas of these vessels, and also their areas of blood supply were recorded in relation to specified landmarks, eg, C-MTH line; medial calcaneal tuberosity to plantar side of the first metatarsal head and S point; emerging point of superficial branch of MPA from deep fasciae into subcutaneous layer.
Average diameter of MPA at its origin and total length are 1.63 ± 0.3 and 52.8 ± 16.1 mm, respectively. It provides 1-3 perforators, with an average size and length of 0.36 ± 0.11 and 23.2 ± 5.47 mm, respectively. Its distribution is mostly in the posteromedial quadrant within 50 and 30 mm from the midpoint of C-MTH line and the S point, respectively. The estimated perforator flap area is 2.5 cm × 1.5 cm and 4.5 cm × 2.5 cm for single and double perforators, respectively.
MPAP flap was proved as another ideal option for finger pulp reconstruction. Its limitation is small size of perforators but this can be overcome by using MPA for microsurgical anastomosis instead.
足底内侧动脉穿支（MPAP）皮瓣被认为是手指 pulp 重建的合适选择。为了提供这种小皮瓣设计所需的以前无法获得的血管信息，本研究旨在收集足底内侧动脉（MPA）、MPAP 及其供血区域的所有必要解剖结构，以应用于临床 MPAP 皮瓣重建，最大限度地减少穿支损伤。
对 30 具泰国尸体足部进行解剖，使用丙烯酸染料插管来观察 MPA 的浅支及其穿支（MPAP）。记录这些血管的直径、长度、分支数量、走行、分布区域以及它们的供血区域，并与特定标志相关联，例如 C-MTH 线；跟骨内侧结节至第一跖骨头足底侧以及 S 点；MPA 浅支从深筋膜进入皮下层的穿出点。
MPA 起始处的平均直径和总长度分别为 1.63±0.3 和 52.8±16.1 毫米。它发出 1 - 3 支穿支，平均大小和长度分别为 0.36±0.11 和 23.2±5.47 毫米。其分布大多在距 C-MTH 线中点和 S 点分别 50 毫米和 30 毫米范围内的后内侧象限。单穿支和双穿支皮瓣的估计面积分别为 2.5 厘米×1.5 厘米和 4.5 厘米×2.5 厘米。
MPAP 皮瓣被证明是手指 pulp 重建的另一种理想选择。其局限性是穿支尺寸小，但这可以通过使用 MPA 进行显微外科吻合来克服。
需注意，原文中“finger pulp”这里的“pulp”结合医学语境可能是指手指的指腹等类似结构，具体准确含义需结合更专业医学知识背景，这里直接按“finger pulp”翻译为手指 pulp 供参考。
