带前臂外侧皮神经营养血管筋膜皮瓣的应用解剖

目的：为带前臂外侧皮神经及其营养血管筋膜皮瓣提供形态学基础。方法：在３２侧成人上肢标本上，观测前臂外侧皮神经营养血管及其周围皮肤的供血情况。结果：前臂外侧皮神经近侧的血供为肱动脉末端和桡动脉起始部的肌皮支，起始处外径分别为１．４ｍｍ、１．１ｍｍ，穿出深筋膜前长为１．９ｃｍ、１．４ｃｍ；远侧主要为桡动脉的粗大皮支，起始处外径为０．８ｍｍ，穿出深筋膜前长０．８ｃｍ；此外，桡动脉的茎突返支及掌浅支的皮支营养其远端。其神经支在神经束间或神经旁相互吻合构成纵向（链式）血管网，并借分支与筋膜皮支所形成的皮下筋膜血管网沟通。结论：可设计带前臂外侧皮神经及其营养血管的筋膜皮瓣，顺行或逆行转位修复邻近部位的软组织缺损。

APPLIED ANATOMY OF FOREARM FASCIOCUTANEOUS FLAP PEDICLED LATERAL FORE- ARM CUTANEOUS NEURAL VESSELS

Objective , To provide anatomic basis for the apply of lateral forearm fasciocutaneous neurovascular flap. Methods : The observaeion and measurement of the lateral forearm cutaneous nerve and its neutrient vessels and blood supplies of its adjacent skin were made on 32 adult cadaver upper ex- tremity specimens. Results : The blood supply of lateral forearm cutaneous nerves origins from the mus- culocutaneous or septa cutaneous perforating vessels of the end segment of brachial artery and original segment of radial artery in the proximal third of the forearm. The mean diameter are 1. 2 mm at their point of origin and length are 1.5 cm before perforated from deep fiscia. However ,in the distal third of the forearm , it origins from a larger cutaneous branch which arose from the exposed part of radial artery. Its average diameter is 0.8 mm and length is 0.8 cm before perforated from deep fascia. Besides , the distal end of lateral forearm cutaneous nerves is nutriented by cutaneous artery arose from the re- current branch of styloid process and superficial palmar branch of radial artery. A longitudinal anasto- mosis (chain-linked system ) of the interneural fascicle and para-nerves was formed by these neutrient branches of lateral forearm cutaneous neural arteries and a broad artery network in superficial fascia around the cutaneous nerves also anastornosed by the cutaneous branches and the neural neutrient ones each other. Conclusions : The lateral forearm fasciocutaneous neurovascular flap ( obedient of adverse transfer)could be designed and used for repairing the soft tissue defects of the adjacent sites.