桡动脉掌浅支蒂腕横纹皮瓣的应用解剖

doi:10.13418/j.issn.1001-165x.2017.05.005

Abstract

Abstract:

Objective　To explore the anatomical basis of blood supply and surgical design method of the wrist crease flap through the anatomical observation of the superficial palmar branch of the radial artery and the cutaneous branches of wrist crease，which could provide anatomical basis for the clinical application of the flap.　Methods　We dissected 6 fresh hand specimens perfused with red latex to observe the course of superficial palmar branch of the radial artery and the regularity and characteristic of the cutaneous branches of wrist crease’s distribution.　Results　Superficial palmar branch of the radial artery started at palm-ulnar side of styloid process of radius from radial artery with an initial diameter of（1.26±0.36）mm，and traveled to the thenar. The cutaneous branches of superficial palmar branch of the radial artery supplied the skin of wrist crease were given off at middle wrist crease with an initial diameter of（0.23±0.06）mm near the proximal aspect of the tubercle scaphoid bone. Conclusion　Wrist crease flap was supplied by cutaneous branches of wrist crease from superficial palmar branch of the radial artery. The flap could be designed as a free skin flap or pedicled skin flap to repair the soft tissue defect of hand. The flap had such advantages as reliable blood supply no main vascular sacrifice, and safe surgery.

Key words: Superficial palmar branch of the radial artery, 　Wrist crease flap, 　Applied anatomy, Repair

ZHANG Wen-long，ZHAO Gang，FANG Jie，SUN Wen-tao，WANG Jian. The applied anatomy and design of wrist crease flap[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(5): 501-503.

References

[1] 许亚军，邱扬，高建军，等. 大鱼际皮瓣[J]. 实用手外科杂志，2002,16（1）：41-42.
[2] Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers [J]. Plast Reconstr Surg, 2003. 111(4): 1412-1420.
[3] 张亚斌，李会晓，夏利锋，等. 桡动脉腕横纹穿支皮瓣的解剖及临床应用[J]. 中华显微外科杂志，2015，38（5）：479-481.
[4] 赵民，邵新中，吴金英，等. 桡动脉掌浅支复合组织皮瓣游离移植修复手指皮肤缺损[J]. 中华手外科杂志，2014，30（5）：333-336.
[5] Tagil SM，Bozkurt MC，Kuvat SV，et al. A variant course of the superficial palmar branch of the radial artery[J]. Surg Radiol Anat, 2012，34（9）：871-873.
[6] Iwuagwu FC，Orkar SK，Siddiqui A. Reconstruction of volar skin and soft tissue defects of the digits including the pulp: experience with the free SUPBRA flap[J]. Plast Reconstr Aesthet Surg，2015，68：26-34.
[7] Lee SH，Cheon SJ，Kim YJ. Clinical application of a free radial artery superficial palmar branch flap for soft-tissue reconstruction of digital injuries[J]. The Journal of Hand Surgery，2017，42（2）：151-156.
[8] Zheng DW，Li ZC，Shi RJ，et al. Thumb reconstruction via a pedicled flap based on the superficial palmar branch of the radial artery from the wrist crease area.[J] Plast Reconstr Aesthet Surg. 2015 Nov，68（11）：1581-1587.
[9] Iwuagwu F，Siddiqui A. Pedicled (antegrade) SUPBRA flap - for wound cover on volar aspect of thumb[J]. Plast Reconstr Aesthet Surg. 2012，65（5）：678-80.
[10]郑大伟，黎章灿，许立，等. 桡动脉掌浅支腕横纹皮瓣在虎口修复中的应用[J].中华解剖与临床杂志，2015，20（1）：45-49.
[11]候桥，李宏烨，岳振双，等. 腕部掌侧桡动脉掌浅支皮瓣修复指腹缺损[J].中华显微外科杂志，2014，37（6）：535-537.
[12]尚修超，张乃臣，刘宏君，等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损[J].中华手外科杂志. 2015，31（1）：77.
[13]王立波，初海坤，孙智颖，等. 腕掌侧桡动脉掌浅支游离皮瓣与指背筋膜皮瓣比较研究[J].中华手外科杂志.2015，31（5）：391-392.
[14]郑大伟，黎章灿，曹广超，等.多种类型的桡动脉掌浅支腕横纹部游离皮瓣修复手指复合软组织缺损[J].中华显微外科杂志，2016，39（1）：12-16.
[15]Cho SH，Bahar-Moni AS，Park HC. Thumb Replantation Using the Superficial Palmar Branch of the Radial Artery[J]. Journal of Hand and Microsurgery，2016，8（2）：106-108.
[16] Chi Z，Yang P，Song D，et al. Reconstruction of totally degloved fingers: a novel application of the bilobed spiraled innervated radial artery superficial palmar branch perforator flap design provides for primary donor-site closure. Surg Radiol Anat. 2016 Oct 21. [Epub ahead of print]
[17] Lee TP，Liao CY，Wu LC，et al. Free flap from the superficial palmar branch of the radial artery (SPBRA flap) for finger reconstruction [J]. J Trauma，2009，64（4）：1173-1179.
[18] 赵民，吴金英，袁作雄，等. 腕部掌侧带血供皮瓣游离移植修复手指缺损的应用解剖研究[J].中国临床解剖学杂志，2013，31（5）：514-517.
[19] 江吉勇，王海文，顾荣，等. 桡动脉掌浅支腕部微型皮瓣移植修复手指皮肤软组织缺损[J]. 中国临床解剖学杂志，2014，31 (06)：729-731.
[20] 刘建标，韩伟杰，马世辉，等. 腕掌侧桡动脉掌浅支游离皮瓣修复手指皮肤缺损并桥接手指动脉[J]. 创伤外科杂志，2014（3）：226-228.

The applied anatomy and design of wrist crease flap

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