Anatomic study of distally based compound flap pedicled with nutrient vessels of the lateral antebrachial cutaneous nerve-cephalic vein

Yanfeng ZHUANG; Fahui ZHANG; Guodong ZHANG

ABSTRACT

BACKGROUND:

Flap pedicled with nutritional vessels of the lateral antebrachial cutaneous nerve is beneficial for repairing injury of dorsum; however, lacks of system researches of the lateral antebrachial cutaneous nerve compound flap.

OBJECTIVE:

To study the anatomic theory of the distally based compound flap pedicled with nutrient vessels of the lateral antebrachial cutaneous nerve - cephalic vein.

DESIGN:

A single sample observation.

SETTING:

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 January to May in 2004.A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.

METHODS:

The radial styloid process was taken as the mark for the microanatomical observation of the follows ① the origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; ② the relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels; ③ the superficial-deep communicating branches of cephalic vein.MAIN OUTCOME

MEASURES:

① The origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; ② The relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels.

RESULTS:

① The origins of nutrient vessels supplying the inferior 1/3 segment of the lateral antebrachial cutaneous nerve were 6 to 11 cutaneous branches of radial artery with an outer diameter of (0.7±0.3) mm, 2 to 6 cutaneous branches of superficial palmar branch, with an outer diameter of (0.5±0.3) mm, 1 to 2 cutaneous branches of recurrent branch nourishing the radial styloid process with an outer diameter of (0.8±0.1) mm, 1 to 2 cutaneous branches nourishing tabatiere anatomique with an outer diameter of (0.6±0.2) mm. 8.0 to 15.0 cm superior to the radial styloid process, there were 1 to 3 spatium intermuscular osteocutaneous perforators of radial artery with an outer diameter of (1.1 ±0.2) mm, and periosteal branches distributed in the denudate area of the middle-inferior radial bone with its cutaneous branches (0.8±0.2) mm in diameter. Above perforators gave rise to cutaneous branches, fascia branches,periosteal branches and nutrient vessels of nerve to superficial vein to form a vessel chain of cutaneous nerve-cephalic vein and vascular networks of deep fascia, superficial fascia and periosteum.

CONCLUSION:

The nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and the nutrient vessels of muscle, bone and skin are homologous. The compound flap of lateral antebrachial cutaneous nerve-cephalic vein pedicled with the cutaneous branches of radial artery can be applied to repair the distal tissue defects of the hand by rotating the flap on the plane of wrist joint.