尺动脉腕上皮支下行支皮支链岛状皮瓣的应用解剖

目的　为尺动脉腕上皮支下行支皮支链岛状皮瓣修复前臂和手指缺损提供解剖学基础。方法　12侧肘关节以上部位截肢的上肢新鲜标本,10侧采用乳胶灌注肱动脉，2侧用乙酸乙酯和塑料灌注肱动脉制作铸型标本，解剖观测尺动脉腕上皮支下行支皮支的起始、走行、分布和吻合情况，并对其外径进行测量。  结果　以尺骨茎突尖端到手背尺侧第5掌指关节部位作为一个单位长度。尺动脉腕上皮支下行支发出的远段皮支2.3支，远段皮支血管聚集点约在第5掌骨颈部，到第5掌指关节的距离占总单位长度的(18.2±7.0)%; 近段皮支4.4支，近段皮支血管聚集点约在第5掌骨基底部，到第5掌指关节的距离占总单位长度的 (66.4±16.7)%。尺动脉腕上皮支下行支皮支在桡尺侧的分布无显著性差异。尺动脉腕上皮支下行支皮支在手背尺侧浅筋膜内相互吻合，形成与尺动脉腕上皮支下行支相平行的皮支链，并营养相应的皮肤。  结论　尺动脉腕上皮支下行支皮支链岛状皮瓣可用于修复手指或前臂较小的皮肤缺损，而且不损伤其主干血管。

Clinical anatomical study of chain-link island flap based on the descending branches of supracarpal cutaneous branches of the ulnar artery

Objective　To provide the anatomical information for covering the defect on the hand and forearm with the chain-link island flap pedicled with the descending branches of supracarpal cutaneous branch of the ulnar artery.　Methods　A total of 12 fresh cadaveric upper extremities that were divided from the elbow joint were used in the research:10 specimens were perfused with red latex for microanatomy, 2 specimens were perfused with plastic and eroded to be vascular cast mold to observe the origin，course, diameter and linking form of the descending branches of supra carpal cutaneous branch of the ulnar artery. Results　The distance from the ulnar styloid process to the fifth metacarpophalangeal joint on the ulnar dorsum of hand was assumed as a unit, the two cluster points of cutaneous clusters of the descending branches of supra carpal cutaneous branch of the ulnar artery were in the location of 18.2%±7.0% that contain 2.3 perforators and 66.4%±16.7% that contain 4.4 perforators. There was no significant difference on the radial and ulnar side distribution of the cutaneous branches arising from the descending branches of supracarpal cutaneous branches of the ulnar artery. The cutaneous branches extended from the descending branches of supra carpal cutaneous branch of the ulnar artery linked each other to form a vascular chain paralleled to the main blood and provided the blood to the skin. 　Conclusions　The chain-link flap is available to repair the small tissue defect in hand or forearms  with the reservation the main vessel.