CAJ | 학술논문

目的观察前臂后外侧中段穿支皮瓣的解剖学.方法在30侧动脉内灌注红色乳胶的成人上肢标本上,以肱骨外上髁为观测标志点,手术放大镜下重点解剖观测:(1)前臂后外侧中段穿支的起源、分支与分布;(2)穿支与周围血管间吻合关系.另在2侧新鲜标本上分别进行墨染和模拟手术设计.结果来源于骨间后动脉桡侧肌皮支、桡动脉肌间隙支和桡动脉直接骨膜支的前臂后外侧中段穿支,穿出深筋膜的位置相对恒定,在指伸肌与桡侧腕短伸肌的肌间隙、旋后肌与拇长展肌之间、肱骨外上髁下12.5～15.8 cm范围内穿过深筋膜至皮下,并分出众多的细小血管与邻近的肌皮穿支血管、前臂后皮神经外侧支的神经旁和神经干血管链的分支密切吻合,在指伸肌与桡侧腕短伸肌之间形成顺沿肌间隙和前臂后皮神经外侧支纵轴的血管丛.结论以前臂后外侧中段穿支为蒂,可形成轴型皮瓣或跨区域供血皮瓣转位修复前臂及腕部软组织缺损.
목적 관찰전비후외측중단천지피판적해부학.방법 재30측동맥내관주홍색유효적성인상지표본상,이굉골외상과위관측표지점,수술방대경하중점해부관측:(1)전비후외측중단천지적기원、분지여분포;(2)천지여주위혈관간문합관계.령재2측신선표본상분별진행묵염화모의수술설계.결과 래원우골간후동맥뇨측기피지、뇨동맥기간극지화뇨동맥직접골막지적전비후외측중단천지,천출심근막적위치상대항정,재지신기여뇨측완단신기적기간극、선후기여무장전기지간、굉골외상과하12.5～15.8 cm범위내천과심근막지피하,병분출음다적세소혈관여린근적기피천지혈관、전비후피신경외측지적신경방화신경간혈관련적분지밀절문합,재지신기여뇨측완단신기지간형성순연기간극화전비후피신경외측지종축적혈관총.결론 이전비후외측중단천지위체,가형성축형피판혹과구역공혈피판전위수복전비급완부연조직결손.
Objective To observe the anatomy of the perforator flap of the posterolateral midforearm. Methods Lateral condyle of the humems wag taken as the observation mark on 30 specimens of adult upper limb perfused with red latex.The surgical magnifier Wag used to obse~e the origin,branches and distribution of the perforating branches of the posterolateral midforearm as well as alanagtomosis between perforating branches and peripheral vessels.Mimic operation WaS performed on the two sides of the fresh specimen.Results The perforating branches of the posterolateral midforearm originated from the radial musculoculancous branches of the posterior interosseous artery,the intermuscular branches of the radial artery and the direct periosteal branch of the radial artery had relatively stable location of piercing the deep fascia.Then,the perforating branches of the posterolateral midforearm pagsed through the deep fascia to the subcutaneous part among the spatium intermusculare of extensor digitorum and extensor carpi radialis brevis,supinator and abductor pollicis longus(within 12.5-15.8 cm below the lateral condyle of the humerus).Large number of small blood Vessels were also separated and closely aligned with the musculoculancous branches vascular,perineural and neural stem vascular chain of lateral branches of posterior antebrachial cutaneous nerve.Then,the vascular plexus was formed along the spatium intermusculare and lateral branches of posterior antebrachial cutaneous nerve longitudinal axis between extensor digitorum and extensor carpi radialis brevis. Conclusion The axial pattern flaps or cross-regional blood supply skin flap pedicled with the perforating branches of the posterolateral midforearm Can be formed to repair the soft tissue defect of tlle forearm and wrist.