Shibata M, Ogishyo N
Department of Orthopaedic Surgery, Niigata University School of Medicine, Japan.
Plast Reconstr Surg. 1996 Apr;97(4):746-55. doi: 10.1097/00006534-199604000-00010.
Free flaps based upon the anterior interosseous artery were defined anatomically by 15 dissections. The anterior interosseous artery runs distally for the entire length of the anterior interosseous nerve on the palmar surface of the interosseous membrane. A dorsal branch of the anterior interosseous artery penetrates the interosseous membrane about 5 cm proximal to the distal radioulnar joint and gives off a tributary radially. This tributary ascends the ulnar aspect of the radius to provide blood to the radius and the dorsal wrist skin. Based on these anatomical findings, four types of free flaps were possible: fasciocutaneous, osteocutaneous, neurovascular flaps, and one muscle flap. All seven dorsal wrist flaps successfully covered the defects. Three of four nerve flaps demonstrated patency of the arterial pedicle with digital Allen's test and good sensory recovery of the reconstructed area. One reconstruction of Blauth type II hypoplastic thumb using an ipsilateral pronator quadratus free-muscle flap provided a functionally and cosmetically satisfactory result.
通过15次解剖从解剖学角度对基于骨间前动脉的游离皮瓣进行了定义。骨间前动脉在骨间膜掌面沿骨间前神经全长向远端走行。骨间前动脉的一个背侧分支在远侧桡尺关节近端约5厘米处穿破骨间膜，并向桡侧发出一条分支。该分支沿桡骨尺侧上升，为桡骨和腕背皮肤供血。基于这些解剖学发现，可形成四种类型的游离皮瓣：筋膜皮瓣、骨皮瓣、神经血管皮瓣和一种肌皮瓣。所有七例腕背皮瓣均成功覆盖了缺损。四例神经皮瓣中有三例通过指动脉Allen试验显示动脉蒂通畅，重建区域感觉恢复良好。使用同侧旋前方肌游离肌皮瓣对Blauth II型发育不全拇指进行的一次重建在功能和外观上均取得了令人满意的效果。
