Ge X Z, Huang G K
Department of Orthopaedic Surgery, Lianyungang First People's Hospital, PR China.
Microsurgery. 1996;17(4):180-3. doi: 10.1002/(SICI)1098-2752(1996)17:4<180::AID-MICR3>3.0.CO;2-P.
Three techniques that use distal arteries for microvascular reconstruction in forearm and hand surgery are described: (1) distal based supply from the deep branch of the radial artery, (2) proximal reversal of the radial artery, and (3) distal based supply from the ulnar artery. Nine cases are described to illustrate the use of these techniques: three vascularized bone grafts, three toe-to-hand transfers, one free cutaneous flap, one brachial artery reconstruction, and one replantation of an amputated palm. The technique offers a number of advantages: (1) it eliminates the need for vein grafts, (2) it requires only a single arterial microvascular anastomosis, (3) it minimizes microvascular size discrepancies, (4) the distal artery can be prepared in the same operative field as the rest of the reconstruction, and (5) the technique enables an undamaged artery to be brought into a zone of trauma and used as a recipient vessel. The technique has the disadvantage that it sacrifices part of the collateral circulation to the hand and it is therefore important to check the blood supply to the hand preoperatively.
（1）桡动脉深支的远端供血；（2）桡动脉近端翻转；（3）尺动脉的远端供血。文中描述了9例病例以说明这些技术的应用：3例血管化骨移植、3例足趾移植到手、1例游离皮瓣、1例肱动脉重建以及1例断掌再植。该技术具有诸多优点：（1）无需静脉移植；（2）仅需进行一次动脉微血管吻合；（3）使微血管大小差异最小化；（4）远端动脉可在与重建手术其他部分相同的手术区域进行准备；（5）该技术能将未受损的动脉引入创伤区域并用作受体血管。该技术的缺点是牺牲了手部的部分侧支循环，因此术前检查手部血供很重要。
