From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Toulouse University Hospital, Hôpital Rangueil; Department of Orthopaedic Surgery, Mayo Clinic; Departments of Plastic and Reconstructive Surgery and Orthopaedic Surgery, Institut Universitaire Locomoteur et Sport, and Service de Chirurgie Viscérale d'Urgence, Hôpital Pasteur 2, University of Côte d'Azur; Department of Plastic, Reconstructive, and Aesthetic Surgery, Orléans Hospital; and Laboratoire d'Anatomie Normale, Faculté de Médecine de Nice, Université Côte d'Azur.
Plast Reconstr Surg. 2022 Jan 1;149(1):163-167. doi: 10.1097/PRS.0000000000008629.
Digital neurovascular bundle defects are often encountered during crush or avulsion injuries and require complex reconstruction. Use of an arterialized nerve graft (neurovascular graft) serving both as an interpositional arterial conduit and as a nerve graft could be a reconstructive option in these cases. In this anatomical study, the authors aimed to describe a neurovascular graft of the posterior interosseous nerve and a branch of the anterior interosseous artery for neurovascular bundle reconstruction of the fingers.
Eighteen forearms were injected with red latex in order to collect the anatomical characteristics of the posterior interosseous nerve and the artery running near it.
In all cases, the posterior interosseous nerve was followed by a branch of the anterior interosseous artery: the distal dorsal branch of the anterior interosseous nerve. The origin of this artery was proximal to the radiocarpal joint, at an average of 56.5 ± 11.1 mm. The proximal and distal diameters of the branch of the anterior interosseous artery were 1.6 ± 0.2 and 1.1 ± 0.2 mm, respectively. The proximal and distal diameters of the posterior interosseous nerve were 1.2 ± 0.3 mm and 1.1 ± 0.3 mm, respectively.
These results show that a potential free neurovascular graft using the posterior interosseous nerve as nerve graft and the anterior interosseous artery as an arterial bypass to reconstruct both the nerve and arterial tree of the finger could be a useful approach. The authors speculate that this graft could be used to reconstruct the neurovascular bundle of amputated or devascularized digits.
在挤压伤或撕脱伤中经常会遇到神经血管束损伤，需要进行复杂的重建。使用作为间置动脉导管和神经移植物的动脉化神经移植物可能是这些情况下的一种重建选择。在这项解剖学研究中，作者旨在描述一种用于手指的神经血管束重建的后骨间神经和前骨间动脉的神经血管移植物。
将 18 个前臂注射红色乳胶，以收集后骨间神经和其附近动脉的解剖特征。
在所有情况下，后骨间神经都有前骨间动脉的分支：前骨间神经的远端背侧支。该动脉的起源位于桡腕关节近端，平均为 56.5 ± 11.1 mm。前骨间动脉的近端和远端直径分别为 1.6 ± 0.2 和 1.1 ± 0.2 mm。后骨间神经的近端和远端直径分别为 1.2 ± 0.3 mm 和 1.1 ± 0.3 mm。
这些结果表明，使用后骨间神经作为神经移植物和前骨间动脉作为动脉旁路来重建手指的神经和动脉树的潜在游离神经血管移植物可能是一种有用的方法。作者推测，这种移植物可用于重建断指或去血管化手指的神经血管束。
