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目的为远端蒂尺侧上副动脉穿支皮瓣设计提供解剖学基础。方法通过对14侧红色乳胶灌注的新鲜成人上肢标本进行显微解剖,观测尺侧上副动脉穿支的起源、走行、数量、外径及吻合情况。结果尺侧上副动脉起点距肱骨内上髁上方(16.6±1.9)cm,外径(1.6±0.2)mm,穿支动脉出现率93%,在尺侧上副动脉全程都有分布,管径0.5～1.3 mm之间,并在深筋膜表面形成纵向稠密的血管吻合网。远端穿支位置相对恒定,距肱骨内上髁上方距离(3.3±1.2)cm,管径(0.9±0.3)mm,并与尺侧下副动脉、尺侧返动脉发出的皮肤穿支形成血管吻合,有1～2条伴行静脉,直径(0.8±0.4)mm。结论尺侧上副动脉穿支所形成的血管吻合网血供可靠,远端穿支管径较粗、位置恒定,以肱骨内上髁上方3 cm尺侧上副动脉远端穿支穿出点为皮瓣旋转点,以臂内侧中下部皮肤为供区,不携带尺侧上副动脉,设计远端蒂尺侧上副动脉穿支皮瓣,可用于修复肘关节皮肤缺损。
Objective To provide an anatomical basis for the design of distal femoral perforator flaps. Methods The microsurgical anatomy of fresh adult upper limbs infused with red latex on the 14 sides was performed to observe the origin, path, number, diameter and anastomosis of the perforator. Results The ulnar side of the accessory arteries had a diameter of 16.6 ± 1.9 cm above the medial epicondyle and a diameter of 1.6 ± 0.2 mm. The incidence of perforation arteries was 93%. The accessory arteries were distributed throughout the ulnar side, 0.5 ~ 1.3 mm between the deep fascia and the formation of longitudinal dense vascular anastomosis network. The location of the distal perforator was relatively constant, with a distance of (3.3 ± 1.2) cm and a diameter of (0.9 ± 0.3) mm from the supracondylar portion of the humerus, and the perforating branch of the skin from the ulnar inferior artery and ulnar accessory veins Anastomosis, there are 1 to 2 accompanying veins, diameter (0.8 ± 0.4) mm. Conclusions The anastomosis blood vessels formed by the perforator of ulnar artery are reliable and the diameter of the distal perforator is thicker and the position is constant. The perforation of the distal perforator distal to the 3 cm ulnar upper humerus is Flap rotation point, to the medial arm of the middle and lower skin for the area, do not carry the ulnar on the deputy artery, distal ulnar artery design of perforator flap, can be used to repair the elbow skin defect.