带臂外侧上皮神经及其营养血管筋膜皮瓣的应用解剖

目的:为带臂外侧上皮神经及其营养血管筋膜皮瓣提供解剖学基础.方法:32例经灌注红色乳胶的成人上肢标本,对臂外侧上皮神经及其营养血管等进行了较详细的应用解剖学研究.结果:臂外侧上皮神经在均由腑神经发出,起点横径为1.5±0.4mm,在三角肌深方斜向外下3.6±1.1cm从该肌后缘中1/3浅出肌间隔,分为上支和下支,分布于三角肌后部、外侧部和臂外侧上部.该神经的营养血管起源于旋肱后动脉,起点外径为0.9±0.4mm;其行程、分支和分布均同在神经,供血范因为14.8×9.8cm~2,并与周围的皮动脉存在丰富吻合.结论:带臂外侧上皮神经及其营养血管筋膜皮 瓣可视受区需要设计成游离瓣或旋转瓣,用于修复邻近部位、手或颌面部缺损.

APPLIED ANATOMY OF THE FASCIOCUTANEOUS FLAPS BASED ON THE SUPERIOR LATERAL BRACHIAL CUTANEOUS NEURAL VESSELS

To provide anatomic basis for the applly of the superior lateral brachial fasciocutaneous neurovascular flap. Methoda: Applied anatomic studies of the superior lateral brachial cutaneous nerves and its vessels were made on 32 adult cadaver upper limb specimens. Results: The superior lateral brachial cutaneous nerve is the terminal sensory branch of the axillary nerve and is 1.5±0.4mm in diameter at its point of origin. It gives direct motor innervationto the deltoid muscle before emerging at the middle 1/3 of posterior border, where it is divided into superior and inferior bandies of which the former turns cranially to supply the skin over the posterolateral deltoid muscle, the latter runs anteroinferiorly to supply the skin over the long head of the triceps muscle. Its artery arises from the posterior humeral circumflex artery and it is 0.9 ±0.4 mm in diameter at its point of origin, It, accompanied the cutaneous nerve,also supplies the skin over the posterolateral deltoid muscle and long head of trices muscle, and its blood supply area is 14.8cm in length and 7 cm in width. Conclusions: The fasciocutaneous flaps based on the superior lateral brachial cutaneous neural vessels can be according to the need of recipient defects, designed free and rotating flaps which would use for reconstruction of adjacent region, hand and maxillofacial defects.