Abstract:

Objective　To provide anatomical basis for the neurocutaneous vascular flap pedicled with posterolateral mid-forearm perforators.　Methods　30 embalmed upper limbs of adult cadavers perfused with red latex were used for this anatomical study, and the followings were observed :①The course and distribution of the posterior antebrachial cutaneous nerve；②Anastomoses between posterolateral mid-forearm perforators and nutrient vessels of the antebrachial cutaneous nerve. Mimic operation was performed on one side of fresh specimen.　Results　①The trunk of posterior antebrachial cutaneous nerve run on the dorsal forearm，descending to the wrist between the extensor digitorum and extensor carpi ulnaris, and innervated about 1/3 area of the posterolateral forearm. ②the nutrient vessels were made up by segmental perforators of multiple origins. The posterolateral mid-forearm perforators whose locations were relatively constant travelled in the intermuscular septum between the extensor digitorum and extensor carpi radialis brevis or the supinator and abductor pollicis longus , and pieced the deep fascia to the subcutaneous tissue (range: 12.5 ~ 15.8 cm below the lateral condyle of humerus). A large number of small arterial branches were given off by those perforators, which anastomosed with the perineural and intraneural nutrient-vessel links of the antebrachial cutaneous nerve, forming a longitudinal vascular plexus along the intermuscular septum between the extensor digitorum and extensor carpi radialis brevis and around the anterbrachial cutaneous nerve.　Conclusions　 The neurocutaneous vascular flap pedicled with posterolateral mid-forearm perforators can be developed to repair soft tissue defects of the forearm and wrist.

Key words: Forearm injuries, Perforating branches, Surgical flap, Posterolateral forearm, Transposition