尺动脉腕背支骨膜瓣修复三角纤维软骨的应用解剖

Applied Anatomy of Periosteal Flap of Dorsal Carpal Branch of Ulnaris Artery for Repairing Triangular Fibrocartilage Complex Lesions

目的 为三角纤维软骨修复提供新的手术方法。 方法 在 4 0侧经动脉灌注红色乳胶的成人尸体标本上 ,解剖观测尺动脉腕背支的走行、分支及分布。 结果 尺动脉腕背支在豌豆骨近侧 3.9± 1 .2 cm处起于尺动脉 ,经尺神经前方 (少数经后方 ) ,在尺侧腕屈肌与尺侧腕伸肌间隙穿出后 ,分为升支和降支。升支穿深筋膜沿前臂尺侧缘上行 ,与前臂尺侧其他皮支相吻合 ,降支粗大 ,经尺骨头前方与豌豆骨之间进入手背 ,与小指掌背动脉尺侧支或掌深弓小鱼际支相吻合。升、降支分别在起始处发出 1～ 3支、外径 0 .2～ 0 .7m m骨膜支营养尺骨远端前内面的骨膜。 结论 在升、降支分支前结扎尺动脉腕背支 。

Objective\ To provide a new therapeutic method for the treatment of triangular fibrocartilage complex(TFCC).\ Methods\ Observed the course, branches and distribution of the dorsal carpal branch of ulnar artery by anatomising the adult cadaver specimens perfused with red latex at 40 side artery.\ Results\ The dorsal carpal branch of ulnar artery arise from the ulnar artery at 3.9±1.2 cm distally of pisiform bone.\ Pass infront of the ulnar nerve(minority was through the rear), emerge from the gap between the ulnar flexor muscle of wrist and ulnar extensor muscle of wrist.\ It was divided into the ascending branch and the descending branch, the ascending branch go up along with the margin of forearm go through the deep fascia, anastomosed with the other forearm ulnaris cutaneous branches.\ The descending branch, which was bulky, enter the back of hand through the front of ulna head and the pisiform bone, and was anastomosed with the little finger artery ulnaris or deep palmar arch hypothenar.\ On the origin, the ascending branch or descending branch respectively send off 1~3 pieces periosteum branch with diameter 0.2~0.7 mm.\ Conclusion\ It is an practical method to achieve the transposition of inferior ulnaris periosteal flap with the dorsal carpal branch of ulnaris artery pedicle for repairing TFCC.