骨间后动脉肌间隙支穿支皮瓣的解剖学研究

An anatomical study of the perforating branch flap with intermuscular septum branch of posterior interosseous artery

目的通过研究骨间后动脉肌间隙支穿支血管在皮肤内的走行和分布，探索骨间后动脉肌间隙支穿支皮瓣对手部小面积皮肤软组织缺损进行精确的定点修复的可能性。方法红色乳胶灌注的上肢标本14侧，解剖观测外径≥0．5mm的穿支，测量其管径并观察其走行、分支、分布情况等。结果骨间后动脉发出4～5支肌间隙支血管供应皮肤。其中最大的骨间后动脉肌间隙支穿支起自肱骨外上髁至尺骨小头桡侧缘连线，距腕横纹上8～9cm[平均（8．9±2．0）cm]，其他各肌间隙支穿支分别以3．0～5.5cm间隔发出，每个穿支斜行0．6—1．6cm穿过肌间隙到达皮肤。蒂长（1．8±0.1）cm，穿支外径0．3～0．6mm[平均（0．5±0．1）mm]，均有两条伴行静脉。结论骨间后动脉肌间隙支穿支皮瓣对手部小面积皮肤软组织缺损精确定点修复提供解剖学依据。

Objective To study whether it is feasible to perform accurate fixed-point repair of small defects of hand soft tissue with the perforating branch flap with intermuscular septum branch of posterior interosseous artery. Methods We collected 14 limb specimens perfused with red latex to dissect the perforating branch flaps with outside diameters no less than 0. 5 mm. We measured their diameters, courses, branches and distribution. Results The posterior interosseous artery has 4 to 5 intermuscular septum branches to supply blood for skin. The largest one which lies 8 to 9 cm （8.9 ± 2.0） above wrist stripes o- riginates from the line between lateral epicondyle of humerus and capitulum ulnae. The other ones are 3 to 5.5cm apart from each other, each running 0. 6 to 1.6 cm obliquely through the intermuscular septum and arriving at skin. All the main pedicles are about （ 1.8 ± 0.1 ） cm and their calibers are about 0. 3 to 0. 6 mm （0. 5 ± 0. 1 ）. Each perforating branch has two accompanying veins. Conclusion It is feasible to perform accurate fixed-point repair of small defects of hand soft tissue with the perforating branch flap with intermus- cular septum branch of posterior interosseous artery.