尺侧返血管背侧支尺骨上段骨膜瓣移位术的应用解剖

Applied anatomy for the transposition of the proximal ulna periosteal flap pedicled with dorsal branch of ulnar recurrent vessels

目的 :为治疗肱骨干骨不连提供一种新的骨膜瓣供区。方法 :在 3 0侧成人上肢标本上解剖观察了尺侧返血管的起始、走行、分支、分布及其与尺侧下副动脉的吻合关系。结果 :尺侧返动脉始于尺动脉上段 ,距肱骨内上髁 (5 .3± 1.0 )cm ,外径 (1.9± 0 .3 )mm ,分出掌侧支和背侧支。背侧支位于尺神经深面 ,沿尺神经沟上行 ,沿途分出 4～ 8支外径在 0 .3～ 1.0mm的骨膜支 ,分布尺骨上段内侧骨面。结论 :以尺侧返血管背侧支为蒂的骨膜瓣逆行移位可修复肱骨中、下段骨不连。

Objective: To provide a new kind of donor of periosteal flap for repairing the humerus nonunion.Methods:The origins, courses, branches, distributions and anastomosis of ulnar recurrent artery and inferior ulnar collateral artery were observed on 30 adult cadaveric upper limb specimens.Results: The ulnar recurrent artery originated from the proximal ulnar artery 5.3±1.0 cm beneath the medial epicondyle of humerus, with a diameter of 1.9±0.3 mm. It divided into a palmar branch and a dorsal branch.The dorsal branch situated at the deep of ulnar nerve and ascending along the ulnar groove, and divided into 4～8 periosteal braches to the medial upper part of ulna with a diameter of 0.3～1.0 mm.Conclusions: The reversed transposition of periosteal flap pedicled with dorsal branch of ulnar recurrent vessels could be designed for repairing nonunion of the middle distal humerus.etranspos