带血供肱骨下段内侧骨(膜)瓣的移位术

THE TRANSPOSITION OF PEDICLED MEDIAL LOWER PART OF HUMERUS FLAP WITH VESSELS

目的:为上肢骨不连、骨缺损以及肘关节软骨缺损提供一种新的供骨区。方法:选择40侧成人上肢标本,解剖观测了尺侧下副动脉、尺侧返动脉的起始、走行、分布和吻合。通过解剖学研究,设计带血供的肱骨下段内侧骨(膜)瓣移位术治疗骨缺损和骨不连接。结果:从1995年开始,经临床应用9例(肱骨中段骨不连3例,骨缺损2例;尺、桡骨中、上段骨不连3例;肘关节面软骨缺损1例),均取得良好治疗效果。结论:以尺侧下副动脉为供养血管的肱骨下段内侧骨(膜)瓣,血管解剖位置恒定,吻合丰富,可形成多种带血供的骨供区,适于修复肱骨、尺、桡骨骨不连、骨缺损以及肘关节软骨缺损。

Objective:In order to provide a new area of bone flap were supplied for non-unions, osseous defect of upper limbs and chondral defect of elbow joint.Methods:The origin,course,distribu- tion and anastomosis of inferior ulnal collateral artery and ulnal recurrent artery were observed on 40 adult cadaver upper limbs.Based on the results,transposition of pedicled medial lower part of humerus bone flap with vessels was designed.Results:Satisfactary results were achieved in 9 case of patients (non-unions of 3 case and osseous defect of 2 case on medial part of humerus bone;non-unions of 3 case on medial upper part of ulna and radius;chondral defect of 1 case on elbow joint.)Conclusion:This pe- riosteal flap that there are constant vessels and abundant anastomosis with inferior ulnar collateral artery form many area of bone flap were supplied with blood supply for repairing the non-unions,os- seous defect of humerus,ulna,radius and chondral defect of elbow joint.