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尺神经手背支营养血管皮瓣的应用解剖

Applied anatomy of the neurofasciocutaneous flap based on the dorsal branch of ulnar artery

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【作者】 李忠华廖进民刘桂淑张振伟林冷刘畅钟世镇

【Author】 LI Zhong-hua *, LIAO Jin-min, LIU Gui-shu, et al. *Institute of Clinical Anatomy, First Military Medical University, Guangzhou 510515, China

【机构】 第一军医大学临床解剖学研究所湖南省郴州市第一人民医院妇产科深圳市沙井人民医院手外科中心第一军医大学临床解剖学研究所 广州510515广州510515湖南郴州423000深圳518104广州510515

【摘要】 目的 :为带尺神经手背支营养血管的皮瓣提供形态学基础。方法 :在 3 0侧成人上肢标本上 ,观测尺神经手背支营养血管及其与周围皮肤的供血情况。结果 :尺神经手背支的血供近侧端来自尺动脉腕上皮支降支 ,起始处外径为 ( 0 .9± 0 .3 )mm ;远端为第 4或第 3掌背动脉。起始处外径分别为 ( 0 .6± 0 .2 )mm和 ( 0 .7± 0 .2 )mm。其神经支在神经束间和神经旁相互吻合成纵行血管网 ,并借分支与筋膜皮支构成丰富的皮下筋膜血管网。结论 :以尺神经手背支及其营养血管为蒂可形成手背尺侧筋膜皮瓣 ,可顺行或逆行转位修复邻近部位的组织缺损。

【Abstract】 Objective: To provide morphologic basis for the dorsal branches of ulnar nerve and its neurovascular flap. Methods: Blood supply of the dorsal branches of ulnar nerve and its adjacent skin was observed on 30 sides of adult forearm specimens. Results: The blood supply of the dorsal branches of ulnar nerve originated from dorsal branches of ulnar artery in the proximal end, and the outer diameter was 0.9±0.3 mm at its point of origin. In the distal end, it came respectively from the fourth and third dorsal intermetacarpal artery corresponding to the fourth and third reticular space, and their outer diameters were 0.6±0.2 mm and 0.7±0.2 mm at each point of origin. A longitudinal anastomosis of the interneural fascicle and para-nerve was formed by the nutrient arteries of the dorsal branches of ulnar nerve, and a broad network in the superficial fascia around the dorsal branch of ulnar nerve also formed by the cutaneous and neural nutrient branches. Conclusion: The fasciocutaneous flap of dorsal medial hand pedicled with the dorsal branch of ulnar nerve and its nutrient vessels could be proximally or distally transferred to repair neighbour soft tissue defects.

【基金】 广东省科技计划项目 (A30 2 0 2 0 4 0 1 )
  • 【文献出处】 中国临床解剖学杂志 ,Chinese Journal of Clinical Anatomy , 编辑部邮箱 ,2004年01期
  • 【分类号】R322
  • 【被引频次】18
  • 【下载频次】135
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