Roux J L, Leandris M, Allieu Y
Service de Chirurgie Orthopédique II, CHU, Hôpital Lapeyronie, Montpellier, France.
Ann Chir Plast Esthet. 1997 Jun;42(3):260-71; discussion 272-3.
The postero-anterior interosseous flap uses the distal network of the posterior and anterior interosseous arteries. With this flap the authors would like to point out all the possibilities of reverse fascio-cutaneous flaps offered by the interosseus arteries. An anatomic study has been carried out with both a literature review and a cadaveric study. The authors studied the distal interosseous anatomy on 40 fresh upper arms after colored latex injection of the anterior interosseous artery near its origin. A distal anastomosis between anterior and posterior interosseous arteries was present in 38 cases. This anastomosis was situated at an average of 25 mm from the radio-carpal joint. The authors found the fascio-cutaneous artery branch of the anterior interosseous flap in 40 cases, but its origin is variable. Therefore, the anterior interosseous flap was possible in every case but the pedicle length was variable. The surgical technique must begin by a distal exploration of the vascular network. After this exploration the flap is chosen in function with the anatomic possibilities and the cutaneous defect. The authors have already used several kinds of reverse interosseous flap: anterior (6 cases), posterior (11 cases) and recently, postero-anterior (2 cases). With the postero-anterior flap the authors will show the large range of flap possibilities offered by the interosseous arteries for the cutaneous defects of the dorsum of the hand.
骨间后动脉逆行皮瓣利用骨间前后动脉的远端血管网。作者旨在通过该皮瓣指出骨间动脉逆行筋膜皮瓣的所有应用可能性。为此进行了一项解剖学研究，包括文献回顾和尸体研究。作者在40例新鲜上臂上进行了研究，在骨间前动脉起始处附近注入彩色乳胶后，观察其远端解剖结构。结果发现，38例存在骨间前后动脉远端吻合，该吻合平均位于距桡腕关节25mm处。作者在40例中均发现了骨间前皮瓣的筋膜皮动脉分支，但其起源位置各异。因此，每例均可切取骨间前皮瓣，但蒂的长度有所不同。手术技术必须首先从远端探查血管网开始。探查后，根据解剖条件和皮肤缺损情况选择皮瓣。作者已经应用了多种类型的逆行骨间皮瓣：骨间前皮瓣（6例）、骨间后皮瓣（11例），最近还应用了骨间后前皮瓣（2例）。通过骨间后前皮瓣，作者将展示骨间动脉为手背皮肤缺损提供的广泛皮瓣应用可能性。
