旋肱前血管外侧降支为蒂肱骨上段骨膜瓣的应用解剖

Applied anatomy for the upper humerus periosteal flap pedicled with the lateral descending branch of the anterior humeral circumflex artery

目的：为带旋肱前动脉外侧降支为蒂的肱骨上段外侧面骨膜瓣移位术提供解剖学依据。方法：在３８ 侧经动脉灌注红色乳胶的成人上肢标本上对旋肱前动脉外侧降支的来源、走行、分布进行了解剖学观测，并在４ 侧标本上摹拟手术实验。结果：旋肱前动脉经喙肱肌和肱二头肌短头深面，绕肱骨外科颈外进至结节间沟外侧缘分别分出升支和降支。升支上行分布于肱骨头和小结节部。降支有２ 条分别沿胸大肌止腱内、外侧紧贴骨膜下行，为内侧降支和外侧降支。外侧降支下行分布于肱骨上段外侧面三角肌前部所覆盖区。结论：以旋肱前动脉外侧降支为蒂的肱骨上段外侧骨膜瓣移位可用于修复肱骨头缺血性坏死和肱骨近端骨不连或小范围骨缺损。

To provide anatomic basis for the transposition of the proximal lateral humerus periosteal flap pedicled with the lateral descending branch of the anterior humeral circumflex artery.Methods:The origin,course,distribution of the lateral descending branch of the anterior humeral circumflex artery were observed on 38 adult upper limb specimens.Results:The anterior humeral circumflex artery goes beneath the coracobrachial muscle and short head of biceps brachii muscle,the ramifies an ascending and two descending branches at the lateral edge of the intertubercular groove.Two descending branches go close against periosteum and along medial or lateral insertion of the pectoralis major muscle.Lateral descending branch distributes to the area of proximal lateral humerus covered by the anterior part of deltoid muscle.Conclusions:The transposition of the proximal lateral humerus periosteal flap pedicled with the lateral desending branch of the anterior humeral circumflex artery could be designed to repair the proximal humerus.