吻合臂内侧皮神经及其血管筋膜皮瓣的解剖与临床

Anatomy and Clinic of Facio-cutaneous Flap Anastomosing Medial Arm Cutaneous Nerves and Vessels

目的:为带臂内侧皮神经及其营养血管筋膜皮瓣提供形态学基础。方法:在32侧成人上肢标本上,观测臂内侧皮神经营养血管及其周围皮肤的供血情况。结果:臂内侧皮神经的血供为尺侧上副动脉肌间隔皮支、肱动脉肌间隔皮支和尺侧下副动脉肌间隔皮支,起始处外径分别为1.0mm、0.6mm和0.7mm,穿出深筋膜前长为1.5cm、1.1cm和1.2cm。其神经支在神经束间或神经旁相互吻合构成丰富的血管网,并借分支与筋膜皮支所形成的皮下筋膜血管网沟通。结论:可设计成带臂内侧皮神经及其营养血管的筋膜皮瓣,顺行或逆行转位修复邻近部位的软组织缺损。

Objective: To provide anatomic basis for the application of medial arm neurovascular fasciocutaneous flap. Methods: Observation and measurement of the medial arm cutaneous nerve and its neutrient vessels and blood supplies of its adjacent skin were made on 32 adult cadaveric upper limbs. Results: The blood supply of medial arm cutaneous nerves origins from the direct septocutaneous perforating arteries of superior ulnar collateral artery, intermuscular septal artery of the brachial artery and the septocutaneous perforating arteries of inferior ulnar collateral artery. The mean diameter is 1. 0mm,0.6mm and 0.7mm at their point of origin and length, 1. 5cm, 1. 1cm and 1. 2cm, respectively before perforated from deep fiscia. A rich anastomosis of the interneural fascicle and paranerves was formed by these neutrient branches of medial arm cutaneous neural arteries and a broad artery network in superficial fascia around the cutaneous nerves also anastomosed by the cutaneous branches and the neural neutrient ones. Conclusion: The free or rotating (direct or adverse transfer) fasciocutaneous flap based on the medial brachial cutaneous neural vessels, the could be designed and used for repairing the soft tissue defects of the adjacent sites and maxilloface.