前臂后外侧穿支皮瓣游离移植修复手指皮肤缺损的应用解剖

Applied anatomy of using posterior-lateral forearm perforator flap to repair soft tissue defects in the finger

目的介绍前臂后外侧穿支皮瓣游离移植修复手指皮肤缺损的应用解剖。方法解剖观测40侧成人尸体上肢标本,在手术显微镜下进行局部解剖。观测前臂后外侧皮肤的营养动脉、回流静脉、神经支配。结果自桡骨Lister结节及肱骨外侧髁连线中点附近指伸肌和桡侧伸腕肌肌间隙内有一恒定的皮支动脉营养前臂后外侧皮肤,该动脉有两条伴行静脉,神经支配为前臂后皮神经分支,血管蒂长度为(4.12±0.26)cm,血管起始处外径为(0.91±0.07)mm,管径与指动脉相仿。结论前臂后外侧可以形成以桡骨lister结节及肱骨外侧髁连线中点附近的指伸肌和桡侧腕伸肌肌间隙穿支为蒂的穿支皮瓣游离移植修复手指皮肤缺损。

Objective To study the applied anatomical basis of using the posterolateral forearm free perforator flap to repair soft tissue defects in the finger. Methods Forty upper limb specimens were dissected. The origin, distribution and anastomosis of the vessels, nerves in the posterior-lateral forearm were observed with regional anatomy using surgical magnifying glass. Results At the midpoint of line from the radial Lister nodule and the humeral condyle, between the septum of extensor digitorum muscle and extensor carpi radialis muscle, there was an intermuscular septum cutaneous perforator constantly present with two accompanying veins. The posterior antebrachial cutaneous nerve innervated this area. The length of perforator artery pedicle is（4.12±0.26）cm,and the diameter was（0.91±0.07）mm at the origin, which was similar to the digital artery. Conclusion The posterior-lateral forearm can be applied as a free perforator flap pedicled by the intermuscular septum cutaneous perforator artery to repair soft tissue defects in the finger.