前臂背侧部穿支皮瓣的解剖学研究  

An anatomic study of the dorsal forearm perforator flaps

作　　者：王欣[1] 王建红[2] 梅劲[2] 胡浩良[1] 王胜伟[1] 潘佳栋[1] 王杨剑[1] 章伟文[1] 

机构地区：[1]宁波市第六医院手外科,浙江省宁波市315040 [2]温州医学院人体解剖学教研室

出　　处：《中华显微外科杂志》2012年第4期303-306,I0008,共5页Chinese Journal of Microsurgery

基　　金：国家自然基金资助项目（30871308）;宁波市社会发展项目（201IC50033）

摘　　要：目的通过研究前臂背侧部穿支来源、数量、起始、管径、长度、变异情况，为前臂背侧部穿支皮瓣的临床应用提供参考。方法新鲜成人标本10具，行一次性全身动脉造影，另有20侧上肢标本经腋动脉加压灌注红色乳胶。动脉造影标本行CT扫描后，对前臂穿支血管进行三维重建。并对前臂标本进行层次解剖。主要观测外径≥0．5mm的穿支，测量其外径、蒂长及与肱骨外上髁距离等。穿支分布面积应用Scion Image进行测量。结果骨间后动脉在前臂中上段发出（5±2）支穿支供应皮肤。每个穿支斜行0．8-2．7cm，穿过肌间隙后入皮下，蒂长（2．5±0．2）cm，穿支平均外径（0．5±0．1）mm，单穿支供血面积为（22．0±15．O）cm^2。骨间前动脉背侧皮穿支主要分布于前臂远侧1／3段和腕背部，平均直径0．8mm。结论以骨问后动脉穿支为蒂的游离穿支皮瓣，以骨问前动脉背侧穿支为蒂的转位穿支皮瓣，均具有一定的临床应用价值。Objective To provide anatomical landmarks with which to facilitate flap dissection, we studied the perforator artery of the dorsal forearm including its source, quantity, origination, caliber, varia- tion and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture, and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery. The integument of the forearm was dissected, and perforators were identified, including type, course, size and location were documented. Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was （5±2）, the average outer diameter of the perforator artories was （0.5 ± 0.1 ） mm, and the pedicle length was （2.5 ± 0.2） cm. The average cutaneous vascular territory was （22.0 ± 15.0） cm^2. The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It＇s average diameter was 0.8 mm. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.

关 键 词：骨间后动脉 骨间前动脉背侧穿支 穿支皮瓣 血管造影 数字解剖 

分 类 号：R658.2[医药卫生—外科学]