Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
Department of Orthopaedic Surgery, Seikeikai Hospital, Osaka, Japan.
J Reconstr Microsurg. 2020 Nov;36(9):667-672. doi: 10.1055/s-0040-1713601. Epub 2020 Jun 24.
The ulnar artery perforator (UAP) flap, which is hairless, thin, and pliable, has been used for the reconstruction of soft tissues from the finger to the elbow. Preoperative planning is essential for a perforator flap surgery, and there are some tests to identify perforators. Color Doppler ultrasonography (US) with a high-frequency transducer helps in detecting decreased flow in smaller vessels, such as perforators. The purpose of this study was to determine the anatomical locations and origins of perforators arising from the ulnar artery using color Doppler US in healthy volunteers.
Forty forearms of 20 healthy volunteers were included in the study. Perforators arising from the ulnar artery, within 100 mm proximal to the pisiform, were investigated using color Doppler US with a high-frequency transducer.
A total of 205 perforators were identified. On comparing the locations in each 20 mm section from the pisiform, the largest number of perforators was 58 (28%), within 20 mm proximal to the pisiform. The axial view demonstrated 44 (21%), 64 (31%), 32 (16%), and 65 (32%) perforators in the radial, ulnar, superficial, and deep aspects of the ulnar artery, respectively. Fifty-two and 28 essential perforators were supplied by the UAPs arising from the superficial and ulnar aspect within 20 mm proximal to the pisiform and between 21 and 40 mm proximal to the pisiform, respectively, while elevating the UAP flap.
This is the first study to assess the UAP using color Doppler US. Identification of UAP using color Doppler US can be used as a preoperative assessment for reliable elevation of a UAP flap.
尺动脉穿支（UAP）皮瓣无毛、薄且柔韧，已用于从手指到肘部的软组织重建。穿支皮瓣手术需要进行术前规划，并且需要进行一些测试来识别穿支。高频探头的彩色多普勒超声（US）有助于检测较小血管（如穿支）的血流减少。本研究旨在使用彩色多普勒 US 确定健康志愿者尺动脉穿支的解剖位置和起源。
本研究纳入了 20 名健康志愿者的 40 只前臂。使用高频探头的彩色多普勒 US 探查尺动脉在豌豆骨近端 100mm 内发出的穿支。
共识别出 205 个穿支。比较豌豆骨近端每个 20mm 节段的位置，发现最多的穿支为 58 个（28%），位于豌豆骨近端 20mm 内。轴向视图显示，在尺动脉的桡侧、尺侧、浅侧和深侧分别有 44（21%）、64（31%）、32（16%）和 65（32%）个穿支。在豌豆骨近端 20mm 内和 21-40mm 内，分别有 52 个和 28 个关键穿支由尺动脉浅侧和尺侧发出的 UAP 供应，用于抬高 UAP 皮瓣。
这是首次使用彩色多普勒 US 评估 UAP 的研究。使用彩色多普勒 US 识别 UAP 可作为可靠抬高 UAP 皮瓣的术前评估。
