带血管蒂骨膜瓣移位修复肱骨骨不连的解剖与临床研究

Transfer of pedicled periosteum flap for repair of humerus non- union: anatomical and clinical study

目的 探讨带不同血管蒂骨膜瓣移位修复肱骨骨不连的应用价值。方法 通过对旋肱前血管内、外侧降支 ,肱血管肌间隙支 ,桡侧副血管和骨间返血管的应用解剖学研究 ,创用了以上述血管为蒂的骨膜瓣移位术 ,并总结临床应用情况。结果 临床施术 36例 ,效果满意。上述 5种骨膜瓣移位术均各有其适用范围。结论 旋肱前血管外侧降支肱骨上段骨膜瓣适于修复肱骨近端 ;旋肱前血管内侧降支肱骨中段骨膜瓣是修复肱骨上段的理想供区 ,肱血管肌间隙支肱骨中段骨膜瓣供修复肱骨中下段 ,桡侧副血管肱骨下段骨膜瓣适于修复肱骨中段或中下段 ;骨间返血管尺骨上段骨膜瓣逆转移位则用于修复肱骨下段髁上部。

Objective To investigate the value of transfer of periosteum flap pedicled with various vessels for repair of humerus non union. Methods Application anatomy was studied for medial and lateral descending branch of anterior humeral circumflex artery, intermuscular septum branch of humeral artery, collateral radial sided artery and recurrent interosseous artery. Transfer of periosteum flap pedicled by above mentioned artery was done. Results 36 cases were involved with satisfactory outcome. The five transfer of periosteum flap had its respective application. Conclusions Humerus upper segment periosteum flap pedicled by lateral descending branch of anterior humeral circumflex artery was applicable for repair of upper segment defect of humerus, the middle part of humerus periosteum flap pedicled with medial descending branch of anterior humeral circumflex artery for that of upper segment defect of humerus, humerus middle segment periosteum flap pedicled by intermuscular septum branch of humeral artery for that of middle and lower segment of humerus , humerus lower segment periosteum flap pedicled by collateral radial sided artery for that of middle or middle and lower segment of humerus, reverse transfer of upper segment of ulna periosteum pedicled by recurrent interosseous artery for that of supracondylar of lower segment of humerus.