尺侧返血管背侧支前臂上部尺侧皮瓣的应用解剖

Applied anatomy for the transposition of the proximal antebrachium skinned flap pedicled with dorsal branch of ulnar recurrent vessels

目的为肘部软组织缺损修复提供一种新的皮瓣供区。方法 在30侧成人上肢标本上解剖观察了尺侧返血管及其肌皮支的起始、走行、分支、分布,与尺动脉肌皮支、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,起点距肱骨内上髁(5.3±1.0)cm,外径(1.9±0.3)mm,其背侧支位于尺神经深面,沿尺神经沟上行,沿途分出1～2支外径(1.1～0.3)mm的肌皮支,分布前臂上部尺侧。尺动脉近端肌皮支起点距肱骨内上髁下方(8.4±1.4)cm,外径(1.3±0.3)mm。两者肌皮支在皮下相吻合。结论以尺侧返血管背侧支为蒂的皮瓣移位可用于修复肘部周围软组织缺损。

Objective To provide a new kind of donor of skinned flap for repairing the lack of elbow parenchyma. 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 1-2 muscular-sin branch of ulnar artery, (8.4±1.4) cm beneath the medial epicondyle of humerus, with a diameter of (1.3±0.3) mm. Both of the muscular-skin branches anastomosed under the skin. Conclusion The reversed transposition of skinned flap pedicled with dorsal branch of ulnar recurrent vessels could be designed for repairing the lack of elbow parenchyma.