Troisi Luigi, Zanchetta Francesco, Vizcay Macarena, Stucchi Sara, Baez Antonio, Pajardi Eugenio
Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation, San Giuseppe Hospital, IRCCS MultiMedica Group Milan, Milan, Italy.
School of Specialization in Plastic, Reconstructive and Aesthetic Surgery, Milan University, Milan, Italy.
Plast Reconstr Surg Glob Open. 2022 Sep 30;10(9):e4537. doi: 10.1097/GOX.0000000000004537. eCollection 2022 Sep.
The use of the radial artery (RA) as a recipient vessel in the hand is mainly described in the snuffbox. However, we believe that employing the RA distally to the extensor pollicis longus (EPL) tendon may provide remarkable advantages.
We conducted a prospective study from June 2019 until December 2021, which included all patients who underwent reconstructive procedures with the RA distally to the snuffbox as the recipient vessel. We reviewed patients' medical records: demographics, type of trauma, defect characteristics, microsurgical procedure, reoperations, and short- and long-term complications.
We found 23 patients eligible for this study; 22 patients required a reconstructive procedure due to a trauma and one for a congenital malformation. RA distal to snuffbox was always identified and judged reliable and apt as a recipient vessel. There were no issues with the anastomosis and no total flap failure in all cases. The morbidity in the recipient area was also minimal, with no mobility deficits, loss of sensation, or neuroma development.
The RA is the primary vessel in the dorsum of the distal upper limb; performing the anastomosis distally to the EPL tendon may offer various advantages, making the surgery safer and less invasive.
在手部将桡动脉（RA）用作受区血管主要在鼻烟壶处有描述。然而，我们认为在拇长伸肌（EPL）肌腱远端使用桡动脉可能具有显著优势。
我们从2019年6月至2021年12月进行了一项前瞻性研究，纳入了所有以鼻烟壶远端的桡动脉作为受区血管进行重建手术的患者。我们回顾了患者的病历：人口统计学资料、创伤类型、缺损特征、显微外科手术、再次手术以及短期和长期并发症。
我们发现23例患者符合本研究标准；22例患者因创伤需要进行重建手术，1例因先天性畸形。鼻烟壶远端的桡动脉总能被识别，且被判定为可靠且适合作为受区血管。所有病例均未出现吻合问题，也没有皮瓣完全坏死的情况。受区的发病率也很低，没有活动功能障碍、感觉丧失或神经瘤形成。
桡动脉是上肢远端背侧的主要血管；在拇长伸肌肌腱远端进行吻合可能具有多种优势，使手术更安全且创伤更小。
