The Anatomy Characteristics Of Forearm And Superficial Dorsum Pedis Venousarch And Its Applications In The Venous Graftrepairing Of Complex Hand And Foot Trauma

Objective:1. This study is on the anatomy characteristics of forearm and superficial dorsum pedis venous arch.2.To Discuss the application of forearm and superficial dorsum pedis venous arch in complex extremities injury and how to choose the best vein transplantation donor according to the anatomical characteristics and the application research.Methods:1.Choose 100 healthy adults and observe the anatomical characteristics of superficial forearm palm-side venous arch, superficial dorsum pedis venous arch, and dorsal venous arch of hand. In 23 fresh copses, we observe the superficial forearm palm-side venous arch, superficial dorsum pedis venous arch, dorsal venous arch of hand, superficial palmar arch, digital artery arch and plantar artery arch, and statistical analysis their locations, morphologic characteristics, gross morphology, tube diameter and valva characteristics, and observe the characteristics of superficial palmar arch and plantar artery arch.2.Use the superficial forearm palm-side H-type venous arch to transplant and repair complex amputated finger (45 cases,47 fingers), and to restore their blood supply. Use superficial dorsum pedis venous arch to transplant and repair the injured superficial palmar arch and dorsal venous arch of hand for 3 cases, whose blood supply are all restored. Use superficial dorsum pedis venous arch to repair and restore the blood supply of contralateral plantar arterial arch for 1casesResults:1 find that the communicating branches of cephalic vein, median vein and basilic vein form superficial venous arch. There are two superficial venous arch in 93% cases. The distal superficial venous arch is 30-80 mm distant from the Transverse wrise crease,42mm for average, with the length 3-11mm and tube diameter 0.3-0.9mm. Thera is no valva in the arch blood vessel, with many collateral branches,94% cases with more than two.The proximal superficial venous arch is 121-183 mm distant,162 mm for average, with the length 46 mm for average and no valva.The tube diameter of collateral branches are very different from each other, about 1.2 mm-2.3 mm. There are superficial dorsum pedis venous arch in 93% cases, with the average arch length 70.1 mm,100% cases with valva, the average tube diameter of dorsum pedis small saphenous vein 1.25 mm, but 2.83 mm in great saphenous vein. Use the superficial forearm palm-side H-type venous arch to transplant and repair complex amputated finger (45 cases,47 fingers), and to restore their blood supply. Use superficial dorsum pedis venous arch to transplant and repair the injured superficial palmar arch and dorsal venous arch of hand for 3 cases, whose blood supply are all restored and the palm, fingers and propodium are all survival. In those cases the repaired blood are survival well. With the follow-up of 12-18 months post-operation, according to the hand function assessment standard all cases recover well.Conclusion:The superficial forearm palm-side venous arch and superficial palm arch matches well. With few and incomplete venous valve, the collateral branches of venous arch are web-like and with different tube diameters, which can be used to repair the injured superficial palm arch and digital artery. The distal superficial venous arch with no valva matches the collateral branches of digital artery well on length, and is good donor for transplantation in complex finger replantation. The superficial dorsum pedis venous arch is fit for repair the dorsal venous arch of hand and contralateral plantar artery arch with its good length, tube diameter, the form of collateral branches and valva. When there is no suitable superficial forearm venous arch, the dorsal venous arch can be used for transplant and repair the superficial palm arch.