Omokawa S, Ryu J, Tang J B, Han J
Orthopedic Research Laboratory, West Virginia University Health Sciences Center, Morgantown, USA.
Plast Reconstr Surg. 1997 Jan;99(1):116-21. doi: 10.1097/00006534-199701000-00018.
Thirty fresh cadaver hands were injected with a silicone rubber compound (Microfil) and dissected to examine the vascular and neural supplies of the thenar area. In 10 specimens, a selective injection technique was used to determine the extent of skin territory nourished by the superficial palmar branch of the radial artery. The purpose of this study was to clarify the anatomic basis for clinical applications of vascularized free- or island-flap transfers from the thenar area. The superficial palmar branch of the radial artery was found in all hands; the average diameter of the branch measured at its bifurcation site was 1.4 mm (0.8 to 3.0 mm). The constant area nourished by the superficial palmar branch was an area approximately 4 x 3 cm located over the proximal parts of the abductor pollicis brevis and opponens pollicis muscles. These results indicate that a fasciocutaneous flap from the radial thenar region can be raised based on the superficial palmar branch and consistently transferred as a free flap. In 63 percent of the hands dissected, the superficial palmar branch was connected to other arteries in the palm, suggesting that the flap can be transferred as a reverse-pedicle island flap in such hands. Innervation of the flap was provided chiefly by a branch of the superficial radial nerve. The radial aspect of the thenar eminence can provide a new and useful donor source for an innervated and vascularized free- or island-flap transfer for reconstruction of various skin defects of the volar side of the fingers.
对30只新鲜尸体手注射硅橡胶复合物（Microfil），并进行解剖以检查鱼际区的血管和神经分布。在10个标本中，采用选择性注射技术来确定由桡动脉掌浅支供血的皮肤区域范围。本研究的目的是阐明从鱼际区进行带血管游离皮瓣或岛状皮瓣转移临床应用的解剖学基础。在所有的手中均发现了桡动脉掌浅支；该分支在其分叉处的平均直径为1.4毫米（0.8至3.0毫米）。掌浅支恒定供血的区域是位于拇短展肌和拇对掌肌近端部分上方的一个约4×3厘米的区域。这些结果表明，基于掌浅支可以掀起桡侧鱼际区的筋膜皮瓣，并持续作为游离皮瓣进行转移。在63%的解剖手中，掌浅支与手掌中的其他动脉相连，这表明在这些手中该皮瓣可以作为逆行蒂岛状皮瓣进行转移。皮瓣的神经支配主要由桡神经浅支的一个分支提供。鱼际隆起的桡侧可为手指掌侧各种皮肤缺损的重建提供一种新的、有用的带神经血管游离皮瓣或岛状皮瓣供区。
