尺动脉腕背支升支皮瓣的应用解剖学研究

目的　为临床应用尺动脉腕背支升支皮瓣修复手部创面 ,提高治疗效果提供解剖学基础。方法　用新鲜成人男性上肢标本 1 6侧 ,采用显微解剖学技术 ,对尺动脉腕背支升支的起始、走行、分支及分布进行解剖学观察和测量。结果　尺动脉腕背支起始于尺动脉的尺侧 ,距豌豆骨上方 4 2 .6 0± 8.2 0mm ,起始处外径1 .4 6± 0 .32mm ,长 1 1 .4 6± 8.2 0mm。尺动脉腕背支与尺神经手背支伴行 ,穿过尺侧腕屈肌腱的深面 ,从掌侧向后内侧斜行 ,两者成锐角 ,平均 38.6 0± 8.2 0°,行至 1 1 .4 6mm处分为升支与降支。升支穿深筋膜进入皮下组织 ,沿前臂内侧缘上行 1 2 2 .4 0± 1 3.80mm处再分为细小分支 ,升支起始部的外径为 0 .6 2± 0 .2 8mm。结论　尺动脉腕背支升支皮瓣是以尺动脉腕背支升支为蒂 ,可在前臂尺侧设计大面积岛状皮瓣 ,通过转位修复腕部和手部创伤及挛缩瘢痕切除术后的创面 ,不牺牲前臂主要血管 ,手术操作易于掌握

Applied Anatomic Study on the Skin Flaps of the Ascending Branch of Dorsal Carpal Branch of Ulnar Artery

Objective To provide the anatomic data for the clinic use of the skin flap of the ascending branch of dorsal carpal branch of ulnar artery to repair wounds on hand and increase the therapeutic efficacy. Methods By means of microscopic anatomy methods, the ascending branch of the dorsal carpal branch of ulnar artery was observed and measured to ascertain its origin, course, branches, distribution on 16 sides upper limbs of adult fresh cadaver. Results The dorsal carpal branch of ulnar artery originates from the ulnar side of ulnar artery, and its starting point is 42.60±8.20 mm apart from the upper of pisiform with its starting outside diameter 1.46±0.32 mm and length 11.46±8.20 mm. Along with the dorsal hand branch of ulnar nerve, the dorsal carpal branch of ulnar artery passes through the deep surface of flexor carpi ulnaris, leaning from the metacarpus to the ulnar side,forming an acute angle (38.60°±8.20°) with the dorsal hand branch of ulnar nerve, and then the dorsal carpal branch is divided into an ascending branch and a descending one. The ascending branch passes through the deep fascia, arrives at the subcutaneous tissue and then goes up along the ulnar side of forearm. The outside diameter of the starting point of the ascending branch is about 0.62±0.28 mm. The ascending branch goes up along the ulnar side of forearm for about 122.40±13.80 mm. Conclusion The skin flap pedicled with the ascending branch of the dorsal carpal branch of ulnar artery is a sort of fascio cutaneous flap, by which the skin flaps of island shape with large dimensions in the ulnar of forearms can be designed by transposition, the wounds at wrist and hand or post resection of contracture scar can be repaired without damage of the main vessels of the forearm.