Duteille F, Rocchi L, Dautel G, Merle M
Service de chirurgie plastique reconstructrice de l'appareil locomoteur, hôpital Jeanne d'Arc, Dommartin-les-Toul, BP 303, 54201 Toul, France.
Ann Chir Plast Esthet. 2001 Feb;46(1):18-22.
The antecubital flap is a fasciocutaneous strip that has its blood supply provided by the first proximal collateral of the radial artery. This flap was described for the first time in 1983 by Lamberty and Cormack, but it has not been widely used and there have been only a few reports in the literature concerning this procedure. The aim of the present investigation was to demonstrate via an anatomical study and a report on five cases the viability of the various anatomical features of this cutaneous flap, and also its positive contribution to elbow reconstruction. The anatomical study involved eight fresh cadavers (eight upper limbs). An injection of colored prevulcanized latex was made in the humeral artery in the lower third of the arm. The aim was to determine which artery provided blood supply to the flap, its anatomical location, and also to look for possible distal anastomoses which would permit a distal pedicled flap to be removed. Contrary to the findings of other authors, in the present study it was found that the vessel providing blood to the antecubital flap always branched off from the radial artery. However, no anastomoses with distal vascularization were detected, which would have permitted a distal pedicled flap to be obtained. The use of the antecubital flap for elbow coverage was then illustrated by five clinical cases of soft tissue defects of the elbow. This method was found to be reliable, practical, and the flap could be rapidly dissected. Moreover, this particular technique is sensitive, and has an interesting rotational arc. The distal cutaneous island flap has the advantage of limiting scar tissue. A comparison between the antecubital flap and other pedicled flaps has then been made. In conclusion, it appears that this little-known procedure has definite advantages, and that it should be included in the range of surgical techniques that are available for soft tissue reconstruction in the case of elbow defects.
肘前皮瓣是一条筋膜皮条，其血供由桡动脉的第一近端分支提供。该皮瓣于1983年由兰伯蒂和科马克首次描述，但尚未得到广泛应用，文献中关于该手术的报道也很少。本研究的目的是通过解剖学研究和5例病例报告，证明该皮瓣各种解剖特征的可行性，以及其对肘部重建的积极作用。解剖学研究涉及8具新鲜尸体（8条上肢）。在手臂下三分之一的肱动脉中注入彩色预硫化乳胶。目的是确定为皮瓣供血的动脉、其解剖位置，并寻找可能的远端吻合支，以便能够切取远端蒂皮瓣。与其他作者的研究结果相反，本研究发现为肘前皮瓣供血的血管总是从桡动脉分支出来。然而，未检测到与远端血管化的吻合支，因此无法获得远端蒂皮瓣。随后通过5例肘部软组织缺损的临床病例说明了肘前皮瓣在肘部覆盖中的应用。发现该方法可靠、实用，皮瓣可快速解剖。此外，该特定技术灵敏，旋转弧度有趣。远端岛状皮瓣具有限制瘢痕组织的优点。然后对肘前皮瓣与其他带蒂皮瓣进行了比较。总之，看来这个鲜为人知的手术有明确的优点，应纳入肘部缺损软组织重建可用的手术技术范围内。
