臂外侧穿支皮瓣的解剖学分析与初步临床应用

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1、AnatomyandclinicalstudyofthelateralupperarmperforatorflapZhangChengHongAbstractobjective：Tostudytheanatomicalcharacteristicofperforatorslocatedatthelateralupperarmandtoinvestigatethefeasibilityofemployingthelateralupperaimperforatorflapinclinicalreconstruction，espe

2、ciallyforrecoveringthedefectofelbow．Throughthisstudy，weexpecttoprovideanatomicalbasisfordesignandoperationofthelateralupperaimperforatorflap．Methods：14sidesoffreshadultupperextremitycadavers，aUcadaverswereinjectedwithredlatex．Microsurgicalobservationwasconductedreg

3、ardingthedistributionofarterialperforatorsincludingthesourc宅artery，perforatorartery(callbra一一O．5mm)，length，diameter，perforationsiteanditsanastomosiswitheachotheronthesurfaceofdeepfascia．Accordingtothesiteoftheperforator，upperaimflapsbasedonthedistalperforatororthep

4、roximalperforatorweredesigned，whosepivotpoint，axis，dissectionlayeraswellasthevascularboundaryweredefined．Inthebodyafterasuccessfuloperationonthespecimensimulation，clinicalapplicationsandobserveoperationeffect．Results：1．Theoriginoflateralupperaimperforatorsinthe14si

5、deupperextremitycadaversarevariable，itmainlyaregivenofffromaxillaryartery，posteriorhumeralcircumflexartery，humeralarteryandradialcollateralartery．2．63perforatorswerefoundin14cadavers，withanaverageof4．5perforatorsateachside；perforatorswithadiametergreaterthan0．5mmwe

6、re31．Amongthem，20perforatorswithanaveragestartingdiameterof∞。73±O．17)mmandanaveragepre．fasciallengthof(1．1+0．5)cm．werefromtheradialcollateralartery，whichaccountsforaproportionof64．52％．11perforatorswithanaveragestartingdiameterof(o．71±o．24)mmandpre．fasciallengthof(1

7、．9±0．8)cmweregivenofffromhumeralartery，whichaccountsforaproportionof35．48％．3．Theperforatorsfanoutatthesurfaceofdeepfascia，andtheadjacentperforatorsinterlinkwitheachothertoformlongitudinalvascularanastomosiswhosedominantvascularsupplytotheflapisstable，reliable．4．Acc

8、ordingtheanatomicalobservationresult，adistallybasedandproximallybasedupperarmperforatorflapweredesigned：pivotpoint：thepivotpointofproximallybased