前臂背侧远端动脉穿支显微解剖与前臂后皮神经营养血管移植皮瓣的设计(英文)  

Micradissection of distal antebrachial arterial perforators of dorsal forearm and design of flap pedicled with nutrient vessels of posterior antebrachial cutaneous nerve

作　　者：张发惠[1] 郑和平[1] 张国栋[1] 

机构地区：[1]解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2007年第8期1559-1562,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：福建省自然科学基金资助项目(C0510034)~~

摘　　要：背景:前臂后皮肤很适合手背侧修复,但对前臂后皮神经营养血管皮瓣的远端蒂动脉穿支缺少具体可操作性的研究,临床实际应用起来还较为困难。目的:研究前臂背侧远端的动脉穿支,为前臂后皮神经营养血管远端蒂皮瓣、复合瓣的合理设计提出解剖学理论。设计:单一样本观察。单位:解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心材料:实验于2004-05/10在解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心实验室完成。研究材料为33侧动脉灌注红色乳胶成人上肢标本(由南京军区福州总医院军区骨科研究所临床解剖学研究中心提供)。方法:将33侧经成人上肢标本,以尺、桡骨茎突为观测标志点进行显微解剖。主要观察指标:①前臂背侧远端的动脉穿支。②前臂后皮神经远端的营养血管。③营养血管与邻近肌、骨、皮的血供关系。结果:①以指总伸肌为中心,前臂背侧远端的动脉穿支主要循其两侧的肌间隙和腱间隙穿出,构成远端外侧与内侧2条纵向的吻合筋膜血管丛:即前臂背外侧血管丛,以外侧肌间隙为轴线,由骨间前动脉腕背支的外侧终支、桡侧骨皮穿支、骨间后动脉的桡侧骨皮穿支和桡动脉腕背支及其穿支组成;前臂背内侧血管丛:以内侧肌间隙为轴线,由骨间前动脉腕背支的内侧终支、尺侧骨皮穿支、骨间后动脉的尺侧骨皮穿支和尺动脉腕背支及其穿支组成。②上述动脉穿支发皮支、筋膜支和前臂后皮神经营养血管,形成皮神经干血管链以及深、浅筋膜血管网。骨间后动脉的肌骨膜支分布尺骨骨膜,其桡侧骨穿皮支与桡骨中下段裸区的骨膜血管吻合,是构成远端蒂复合瓣的解剖学基础。结论:前臂背侧远端的血供具有多源性、明显纵向性和营养血管同源性的解剖学特点,可以设计3种不同供血的前臂后皮神经营养血管远端蒂�BACKGROUND： Posterior antebrachial skin is beneficial for repairing injury of dorsum of hand; however, according to lacking operative researches on distal pedicel arterial perforators of posterior antebrachial cutaneous nerve nutrient vessel flap, it is still a confusing problem in clinic. OBJECTIVE ： To investigate the features of distal antebrachial arterial perforators of dorsal forearm and provide anatomical theories for suitable designing pedicle flap and compound flap at distal flap pedicled with nutrient vessels of posterior antebrachial cutaneous nerve. DESIGN ： Single sample observation SET-FING： Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. MATERIALS： The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004. Thirty-three upper limbs of adult cadavers perfused with red latex through arteries were provided by Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA. METHODS： Thirty-three adults upper limbs were dissected and observed with microscope with taking rhe styloid process of ulna and radius as pivot point. MAIN OUTCOME MEASURES ： ① Distal antebrachial arterial perforators of dorsal forearm; ②nutrient vessels of distal posterior antebrachial cutaneous nerve; ③ their blood supply relationship with nearby muscle, bone and skin. RESULTS： ① Along extensor digitorum communis muscle, distal antebrachial arterial perforators of dorsal forearm were perforated along bilateral muscular interspace and tendon interspace to form lateral and interior inosculated vascular plexuses of fascia. The axis of lateral muscle interspace, dorsal antebrachial lateral vascular plexuses consisted of lateral branch of dorsal carpal branch of anterior in

关 键 词：外科皮瓣 前臂/解剖学和组织学 前臂/血液供给 前臂/神经支配 

分 类 号：R329.4[医药卫生—人体解剖和组织胚胎学]