摘要
目的为前臂背侧嵌合骨皮瓣的设计提供解剖学基础。方法在22例成人上肢标本上解剖，观测骨间后动脉皮支分布，支配尺侧腕伸肌神经支与血管交叉点血管的外径及骨间后动脉与前动脉吻合情况。同时观测尺骨茎突近端5cm范围内，尺骨背侧骨膜血管支数目及血运来源。结果骨间后动脉沿途发出6-10个皮支，在深筋膜浅层形成丰富血管网吻合。可分为两种类型，Ⅰ型：间隔1-2cm发出皮支（15例）；Ⅱ型：分远、近两组（7例）。支配尺侧腕伸肌神经支与血管交叉点动脉外径（1．4±0．2）mm。在尺骨茎突近侧（2．4±0．5）cm处骨间后动脉与前动脉腕背支形成恒定吻合。尺骨茎突近侧5cm范围内，骨间后动脉向尺骨远段发出（3．0±0．8）支骨膜支（19例）；骨间后动脉发出2支骨膜支，骨间前动脉背侧支发出1支骨膜支（2例）；骨间前动脉背侧支发出2支骨膜支（1例）。结论以骨间后动脉为蒂可切取前臂背侧皮瓣、尺骨远端骨瓣形成嵌合组织瓣，修复手部皮肤缺损合并小块骨组织缺损。
Objective To provide the anatomical basis for the design of chimeric flap of the dorsal forearm. Methods 22 adult upper limb specimens were anatomized to observe the distributions of posterior interosseous artery and the diameter of vessel where the motor branch to the extensor carpi ulnaris crossed the vessel was measured. The presence of the anastomosis between the anterior and posterior interosseous arteries was also observed. The periosteum branch to the distal ulna and its origin were observed in the distance of 5cm from the ulna styloid. Results The posterior interosseous artery gave 6 to 10 cutaneous branches which formed rich vascular arcades with longitudinal anastomoses. Two distinct patterns could be identified. Pattern I comprised multiple small branches arising at 1 to 2 cm intervals along the total length of the posterior interosseous artery （15 cases）. In pattern Ⅱ the cutaneous branches were distributed in two sub-groups, one proximal and the other distal （7 cases）. The diameter of artery where the nerve branch crossed the vessel was （1.4±0.2）mm. The anastomosis between the anterior and posterior interosseous arteries presented in all dissections at a distance of （2.4±0.5） cm from the ulnar styloid. Within the distance of 5 cm from the ulnar styloid, the posterior interosseous artery gave （3.0±0.8） periosteum branches （19 cases）, the posterior interosseous artery gave 2 periosteum branches combined with the anterior interosseous artery giving 1 periosteum branch （2 cases）, and the anterior interosseous artery gave 2 periosteum branches （1 cases）. Conclusion Based on the posterior interosseous artery, a chimeric flap combined with flap and part of the distal ulnar could be designed, and it could be selected to simultaneously repair the soft tissue defect accompanied with small sized bone defect in hand.
出处
《实用手外科杂志》
2009年第4期205-207,共3页
Journal of Practical Hand Surgery
关键词
骨间后动脉
嵌合皮瓣
尺骨
重建
Posterior interosseous artery
Chimeric flap
Ulnar
Reconstruction
