骨间前动脉腕背支尺骨膜瓣修复三角纤维软骨的解剖学基础

Anatomy on Transposition Complex of the Vascularized Ulna Inferion Extremity Periosteal Flap with Carpal Dorsal Branch of Anterior Interosseous Artery for Repairing Triangular Fibrocartilage

目的:为三角纤维软骨修复提供新的手术方法。方法:在40侧经动脉灌注红色乳胶的成人尸体标本上,解剖观测骨间前动脉腕背支的走行、分支及分布。结果:骨间前动脉腕背支在伸肌腱深面贴骨间膜背侧下行至尺骨茎突上(1.6±0.8)cm处分为内、外侧终支,并分别与尺动脉腕背支、桡动脉腕背支吻合。腕背支近端较恒定地发出尺、桡侧骨皮支,其中尺侧骨皮支经伸肌间隙沿尺骨小头走行,沿途分出皮支和尺骨骨膜支。尺侧骨皮支长(1.4±0.7)cm,外径(0.9±0.2)mm,可提供3.1cm×3.2cm×0.3cm尺骨远段背侧骨膜瓣。结论:可以尺动脉腕背支为蒂设计尺骨远端骨膜瓣转位修复三角纤维软骨的新术式。

Objective:To provide a new therapeutic method for the repairing of triangular fibrocartilage complex(TFCC). Methods:Observing the course,branches and distribution of the dorsal carpal branch of anterior interosseous artery by anatomising the adult cadaver specimens perfused with red latex at 40 side arteries. Results:Dorsal carpal branch of anterior interosseous . artery ran down to the styloid process of ulna along the deep stick of the extensor tendon with the interosseous membrane of the forearm and divided into the inside and outside end branch, which was respectly anastomised with dorsal carpal branch of ulnar artery and dorsal carpal branch of radial artery. The dorsal carpal branch continually send out the cutaneous branches of ulnaris bone and radialis bone, among them the cutaneous branches of ulnaris bone went along the capitumum ulna through the extensor m. interspace, along the road which divide out the cutaneous branch and the ulnar periosteum branches. The cutaneous branches of ulnaris bone which the length was (1.4 ± 0.7) cm with outside diameter( 0.9 ± 0.2) mm, could provide the periosteum petal of the far segment of ulna with dimension 3. 1cm × 3. 2cm×0. 3cm. Conclusion: It is an easy practical method for repairing TFCC to achieve the transposition of ulna inferior extremity periosteal. flap pedicled with dorsal carpal branch of anterior interosseous artery.