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目的 :为肱骨头缺血性坏死提供一种新的显微外科修复方法。方法 :在 3 2侧经动脉内灌注红色乳胶的成人上肢标本上 ,解剖观测了旋肱后动脉的起始、走行、分支、分布及吻合情况 ,设计了以旋肱后血管为蒂肱骨骨膜瓣移位术。结果 :旋肱后动脉在出四边孔即距肱骨大结节顶点下 5 .6± 0 .9cm处发大结节骨膜支和三角肌肌支 ,本干循肱骨外科颈后面向前行并与旋肱前动脉吻合。大结节骨膜支起点管径为 1.2± 0 .2mm ,向大结节顶点走行 ,沿途分 4～ 5条侧支呈扇形分布于大结节后外侧面骨膜 ,供骨面积可达 3 .0cm× 5 .0cm。结论 :以旋肱后血管为蒂肱骨骨膜瓣移位可用于修复肱骨头缺血坏死 ,方法简便实用。
Objective: To provide a new method of microsurgery repair of humeral head ischemic necrosis. Methods: The origin, course, branch, distribution and anastomosis of the posterior humeral artery were observed anatomically on the adult upper limbs with red latex injected through the artery on 32 sides. The humerus periosteum flap Shift surgery. Results: The posterior humeral artery developed large periosteal periosteal branch and deltoid muscular branch at a distance of 4.6 ± 0.9cm from the quadrilateral hole, ie, the apex of humerus tuberosity. Anterior humeral anastomosis. Perigalment periosteal diameter of the starting point of 1.2 ± 0. .2 Mm, to the apex of the large nodules, along the way 4 to 5 branches were fan-shaped distribution in the lateral nodular periosteum, for the bone area up to 3.0 cm × 5 .0cm. Conclusion: The displacement of the humeral periosteal flap pedicled with the posterior humerus can be used to repair the humeral head necrosis. The method is simple and practical.