【摘要】 目的:研究指神经背侧分支及其伴行血管的走行与分布为修复指端软组织缺损提供解剖学依据并临床应用。方法:观察30只新鲜手标本的指神经背侧分支及伴行动脉与动脉网的分布,并在35例指端缺损患者手术中应用。结果:拇指、示指、中指、环指与小指的近节和中节指背的指神经背侧分支均起自桡神经或尺神经的手背支;而拇指的远节和示指、中指、环指、小指的中、远节指背的指神经背侧分支部起自指掌侧固有神经的指神经背侧分支,且有动脉伴行,位置较恒定,易于游离,且示指、中指和环指的中节指背有双重背侧分支分布,作为带神经血管蒂的岛状皮瓣供区最为理想。临床应用35例,皮瓣面积1.8cm×1.2cm～3.0cm×2.1cm,皮瓣全部成活。结论:皮瓣易成活,手术简单,不影响供区血供,感觉运动功能恢复良好,有较高临床应用价值。更多还原

【Abstract】 Objective:To investigate the distribution and supply of the nerve and artery in the back of the fingers,give anatom ic and clinic evidence for clinical repair the defect of fingertips.Methods:The origin,distributions of digital dorsal nerve and ar teries in 30 adult hand specimens were observed with operation microscope.The digital dorsal nerve and its accompanied arter- ies as island flap were used to repair the fingertips defect in 35 cases with fingertips defect.Results:The nerves of the proximal and middle phalanges of the fingers back were supplied by the branches of radial or ulnar nerve.The cutaneous nerves of the middle and distal phalanges of the lingers back,accompanied with artery and localized regularly,were supplied by tile dorsal branches of proper plantar digital nerve.The back of the middle phalanx of the index,middle and ring fingers could be the promise candidate for the island flap with nerve and artery because of their double dorsal nerve supply.The tissue defect of fin gertip in 35 cases had been repaired in clinical practice with dorsal digital island flap.The area of the island flap was 1.8cm×1.2cm～3.0cm×2.1cm and all the flaps survived after the operation.Conclusion:This kind of flap survives easily and the op- eration is easy to perform.The operation will not impair the blood supply,movement and sensational function of the fingers.更多还原