Anatomic study of distally based compound flap pedicled with nutrient vessels of the posterior antebrachial cutaneous nerve

Yanfeng ZHUANG; Fahui ZHANG; Guodong ZHANG

ABSTRACT

BACKGROUND:

Posterior antebrachial skin is beneficial for repairing injury of dorsum,however,the systematic anatomic characteristics of distally based compound flap pedicled with nutrient vessels need to be further studied.

OBJECTIVE:

To investigate the anatomic characteristics of distally based flap pedicled with nutrient vessels of the posterior antebrachial cutaneous nerve and compound flap.

DESIGN:

Single sample observation.

SETTING:

Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALSThe experiment was carried out at the laboratory for Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from October to December 2004.A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.

METHODS:

All 30 adults upper limbs were dissected and observed under the microscope based on the pivot point of styloid process of ulna and radius.The following microdissection was emphasizedThe origins,branches,distribution and anastomosis of nutrient vessels of the posterior antebrachial cutaneous nerve;The blood supply relationship of nutrient vessels of posterior antebrachial cutaneous nerve and vicinal bone and skin.MAIN OUTCOME

MEASURES:

The ordgins and branches of nutrient vessels of posterior antebrachial cutaneous nerve,and whose blood supply relationship with vicinal bone and skin.

RESULTS:

The origin of nutrient vessels of posterior antebrachial cutaneous nerve were as followsProximal part2-6cutaneous perforators of radial collateral artery,with an outer diameter of (0.6±0.3) mm;Distal part3-5 cutaneous perforators of dorsal carpal branch of anterior interosseous artery,with an outer diameter of (0.8±0.2) mm;Others6-9cutaneous perforators of posterior nterosseous artery,with an outer diameter of (0.7±0.3) mm.Posterior interosseous artery sent out 6-8 muscle- periosteum branches with an outer diameter of (0.3-1.0) mm,which distribute on ulnar periosteum;Radial bone-skin perforators of posterior interosseous artery anastomosed with periosteal vessels of mid-inferior bare area of radial bone.All above mentioned cutaneous perforators gave off cutaneous branches,fascia branches,periosteal branches and nerve-nutrient vascular branches,all of which formed a vascular chain of cutaneous nervous stem and vascular networks of deep fascia,superficial fascia and periosteum.

CONCLUSION:

The nutrient vessels of posterior antebrachial cutaneous nerve have the same origins as the vicinal bone-skin nutrient vessels,and the rotation point of its distally based pedicled flap and compound flap can reach the plane of wrist joint,which may be helpful to design a kind of more convenient and simplified flap to repair the distal tissue defects of the hand.