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桡动脉掌浅支逆行皮瓣在肘部的应用:临床系列与文献复习。

Elbow coverage by the descending superficial radial artery flap: a clinical series and literature review.

机构信息

Department of Hand and Upper Extremity Surgery, Edouard Herriot Hospital, 5 Place d'Arsonval, 69003, Lyon, France.

Department of Hand and Upper Extremity Surgery, Saint-Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.

出版信息

Eur J Trauma Emerg Surg. 2024 Aug;50(4):1733-1740. doi: 10.1007/s00068-024-02527-6. Epub 2024 Apr 13.

Abstract

PURPOSE

Soft tissue coverage of the posterior aspect of the elbow requires thin and flexible flaps to adapt to movements without constraining them. The authors report a clinical series of reconstruction by the descending superficial radial artery (DSRA) flap, a proximal forearm perforator flap which use is rarely reported in the literature.

METHODS

Seven patients with a mean age of 50 years (range 24-88 years) were treated for a posterior elbow defect using the DSRA flap with an adipofascial pedicle. The flap was tunneled to the defect in the subcutaneous tissue or raised using the racket-like technique to avoid any pedicle compression.

RESULTS

The mean follow-up was 3.3 months (range 1-12 months). A partial necrosis of the skin paddle occurred in an 88-year-old patient. In the other cases, the flap evolution was straightforward. At the last follow-up, the appearance of the flaps was satisfactory in terms of color, texture, and thickness. No complications were observed at the donor site.

CONCLUSION

The DSRA flap with an adipofascial pedicle is a simple, reliable, and reproducible method for reconstruction of small to moderate-sized defect on the posterior aspect of the elbow. Its use is easier for defects on the posterolateral side, but it can reach the medial olecranon.

摘要

目的

肘部后区的软组织覆盖需要薄而灵活的皮瓣,以适应运动而不限制它们。作者报告了一组使用桡动脉浅降支(DSRA)皮瓣进行重建的临床病例,该皮瓣是一种近端前臂穿支皮瓣,在文献中很少有报道。

方法

7 名平均年龄 50 岁(24-88 岁)的患者因肘部后区缺陷接受了带脂肪筋膜蒂的 DSRA 皮瓣修复。皮瓣通过皮下组织隧道或使用球拍样技术抬高,以避免任何蒂部受压。

结果

平均随访 3.3 个月(1-12 个月)。1 名 88 岁的患者出现皮瓣部分坏死。在其他病例中,皮瓣的演变是直接的。末次随访时,皮瓣的外观在颜色、质地和厚度方面均令人满意。供区无并发症。

结论

带脂肪筋膜蒂的桡动脉浅降支皮瓣是一种简单、可靠、可重复的方法,可用于重建肘部后区小至中等大小的缺陷。对于后外侧的缺陷,其使用更为容易,但也可以到达内上髁。

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