骨间后动脉前臂逆行皮瓣的解剖学研究

Anatomic Study of Reversed Forearm Posterior Interosseous Artery Skin Flap

目的：通过对骨间后动脉的解剖观测,为骨间后动脉逆行皮瓣的临床应用提供解剖学依据.方法：用30侧成人上肢标本,对骨间后动脉及其皮支、吻合支的起始、走行、分布进行解剖观测.结果：骨间后动脉发自骨间总动脉,穿过骨间膜上缘至前臂背侧,经旋后肌和拇长展肌之间在前臂深浅两层伸肌之间下行,沿途发出7～12条皮支营养前臂背侧的皮肤,其终末支（96.7%）在尺骨茎突近端（2.5±0.5）cm处与骨间前动脉的背侧支有弧形吻合支相连接.其皮支分布可达动脉主干两侧6cm范围,近侧达肘平面,远端至腕平面.结论：以骨间后动脉为蒂,可在前臂背侧设计大面积（10cm×8cm）逆行岛状皮瓣,用以修复手部皮肤组织缺损、瘢痕挛缩切除术后创面.

Objective：To provide anatomic basis for clinical application of the reverse posterior interosseous artery （PIA） skin flap by studying the PIA＇ s anatomy. Methods： On 30 sides of adult upper extremity specimens, the origin, course, distribution of PIA and its cutaneous branches and communicating branches were observed and measured by means of microanatomy. Results： PIA arose from common interosseous artery and went straight through superior border of the interosseous membrane, then passed dorsal side of forearm. It appeared between the supinator and the abductor pollicis longus and descended in the posterior compartment of the forearm between the superficial and deep layers of muscles. Its terminal branches curved anastomosed with the dorsal branch of anterior interosseous artery 2.5 ±0.5cm above styloid process of ulna. This anastomosis branch had its high occurrences （96. 7% ） and 7-12 cutaneous branches arose from posterior interosseous artery to supply blood for the skin of dorsal forearm, The cutaneous branches could reach the both sides of the truck of the artery （ apart about 6cm）, the plane of elbow in proximal and the plane of wrist in distal. Conclusions： Given the pedicel with the PIA, the reversed PIA skin flap of island shape with large dimen- sions （ 10cm×8cm） in the dorsal side of forearms can be designed. And by transposition, the hand skin defects or wound surfaces after resecting cicatricial contracture could be repaired.