Anatomical characteristics of the distal pedicled flap of nutrient vessel in basilic vein

Fahui ZHANG; Zhihong ZHANG; Heping ZHENG; Guodong ZHANG

ABSTRACT

BACKGROUND:

Skin flap of nutrient vessel of antebrachial cutaneous nerve is beneficial for repairing injury of distal tissue of hand; thus, it is important for comprehending the correlation of blood supply between distal nutrient vessel of basilic vein and medial cutaneous nerve of bone, skin and forearm to design distal pedicled flap of nutrient vessel of antebrachial cutaneous nerve on clinic.

OBJECTIVE:

To investigate distally arterial perforating branch of ulnar margin of forearm and provide anatomical bases for designing distal pedicled flap of nutrient vessel in basilic vein of ulnar margin of forearm.

DESIGN:

Simple sample study.

SETTING:

Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of 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 PLA from May to October 2004. Thirty 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 Hospitalof Nanjing Military Area Command of PLA.

METHODS:

Samples of lateral upper limbs of 30 adults were dissected as the pivot point of styloid process of ulna with microscope. MAIN OUTCOME

MEASURES:

① Sources of distally arterial perfo- rating branch of ulnar margin of forearm; ② nutrient vessel between perfo- rating branch and basilic vein; ③ correlation of blood supply between nutrient vessel and medial cutaneous nerve of bone, skin and forearm; ④ superficial and deep communicating branch of basilic vein.

RESULTS:

① Sources of distally arterial perforating branch of ulnar margin of forearm, which was derived from 5-9 cutaneous branches ulnar artery with external diameter of (0.7±0.3) mm, 1-3 upper cutaneous branches ulnar artery with the external diameter of (0.6±0.3) mm, 6.0- 16.0 mm above styloid process of ulna, 2-3 cutaneous perforating branches anterior interosseous artery and 1-3 posterior interosseous artery with external diameter of 0.4-1.2 mm, middle and inferior segment of periosteum of ulnar and skins in corresponding areas. ② Arterial perforating branches mentioned above started at cutaneous branches, fascia branches, periosteum branches, basilic vein and nutrient vessel branches of cutaneous nerve to form vascular chains of basilic vein and cutaneous nerve stem and vascular nets of deep, superficial fascia and periosteum.

CONCLUSION:

Nutrient vessel of basilic vein is derived from distally arterial perforating branch of ulnar margin of forearm, and this is homophylic with that of medial cutaneous nerve of bone, skin and forearm. Both of them are anatomical basis to design distal pedicled flap of nutrient vessel in basilic vein. Rotational point of distal pedicled flap can reach wrist joint. The compound flap can be applied to repair to injury of distal tissue of hand.