Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan.
J Reconstr Microsurg. 2012 Mar;28(3):195-8. doi: 10.1055/s-0031-1301071. Epub 2012 Jan 24.
Because of its long and stable pedicle, the radial forearm flap is very useful for salvage operations in which there are few choices of recipient vessels. However, pedicle length deficiency and size discrepancy of anastomotic vessels still exist. In such cases, the radial recurrent artery that bifurcates from the radial artery can be used as an anastomotic vessel. Anatomical variations of the recurrent radial artery were studied in 18 cadavers. The branch types were classified as branch from radial artery (Type A), branch from radial artery root (Type B), branch from brachial artery (Type C), and branch from ulnar artery (Type D). Radial artery and radial recurrent artery diameters were measured. The radial recurrent artery was used as an anastomotic vessel in four salvage operations. Branching type variations were Type A: 61.1%, Type B: 33.3%, Type C: 0%, and Type D: 5.6%. Radial recurrent artery diameter was 1.84 ± 0.59 mm at the 20 mm point from bifurcation. In clinical cases, all flaps survived without any anastomotic difficulties. Thus, anastomosis using radial recurrent artery vessels is recommended as a strategy in free radial forearm transplantation for salvage operations.
由于桡侧前臂皮瓣具有较长且稳定的蒂，因此在吻合血管选择较少的情况下，对于挽救性手术非常有用。然而，仍存在蒂部长度不足和吻合血管大小不匹配的问题。在这种情况下，可以使用桡动脉的桡返动脉作为吻合血管。在 18 具尸体中研究了桡返动脉的解剖变异。将分支类型分为桡动脉分支（A型）、桡动脉根部分支（B 型）、肱动脉分支（C 型）和尺动脉分支（D 型）。测量了桡动脉和桡返动脉的直径。在 4 次挽救性手术中，将桡返动脉用作吻合血管。分支类型的变化为 A 型：61.1%，B 型：33.3%，C 型：0%，D 型：5.6%。在离分叉 20 毫米处，桡返动脉直径为 1.84±0.59 毫米。在临床病例中，所有皮瓣均存活，没有任何吻合困难。因此，建议在游离桡侧前臂移植的挽救性手术中使用桡返动脉血管进行吻合。
