The Micro-anatomic Study On The Perforator Flap Of The Ulnar Forearm

Objective:Through anatomy study of10sides of fresh adult upper limb perfusedwith red latex samples, from the perspective of microscopic anatomy to observePerforasome of ulnar forearm in the deep fascia, Understanding the source ofperforator arteries the blood supply of the Ulnar forearm to provide anatomicalbasis for the design and clinical applications of perforator flap used to repairthe distal forearm, wrist and hand soft tissue defects on the ulnar forearm.Methods:Select10upper fresh adult specimens-5right and5left，to perfusion thered latex specimens self-prepared with the staining emulsion，Archive thespecimens in the plastic bags and then put them in the thermostatic refrigerator,12hours before the start of the experiment at room temperature to thaw.forincision in the medial epicondyle-bowl attachment, epicondyle of the humeruscondyle-the dorsal carpal middle of the connection, the horizon of the ulnarstyloid and Epitrochlear-lateral condyle humerus line, cut the forearm skinincision and observe the location of the perforator artery in the deep fascia，thenumber of branches of the situation, outside diameter of the artery length,pedicle length, branched-chain (network)-like distribution， subcutaneousarterial network，blood supply range etc. Design perforator artery pedicledforearm ulnar perforator artery flap.Results:Artery of the forearm issue a number of perforator artery through the ulnarmuscle gap or septum. Perforator branches in the forearm ulnar Palmar anddorsal were arranged in chains, and these branches of the perforator artery coincide with each other into a network structure in the superficial fascia layerand form perforasome, distribute in the ulnar forearm skin and supply blood.The number of perforator artery of the palm side of the ulnar forearm is4-9with an average of6.5. The diameter of the perforator arteries at the startlocation is0.67±0.16mm, there runs10.86±3.74mm before they branches, thelength of the upstream branch is42.59±9.25mm and the downstream branch is30.62±7.15mm. The distance of the Proximal perforator artery from theEpitrochlear-lateral condyle humerus line is38.10±9.00mm and distalperforator artery from the horizon of the ulnar styloid is31.00±6.50mm.Thedistance of adjacent arteries is35.91±8.42mm. The number of perforator arteryof the dorsal of the ulnar forearm is8-13with an average of9.2. The diameterof the perforator arteries at the start location is0.53±0.18mm, there runs10.11±4.85mm before they branches, the length of the upstream branch is33.82±9.33mm and the downstream branch is32.54±7.81mm. The distance ofthe Proximal perforator artery from the Epitrochlear-lateral condyle humerusline is25.00±4.12mm and distal perforator artery from the horizon of the ulnarstyloid is27.10±8.2mm.The distance of adjacent arteries is28.65±12.60mm.The spacing between adjacent perforator branches of28.65±12.60mm. Thedistribution area of perforator arteries is76.83±21.24cm2. The perforator arteryof Ulnar forearm located on both sides of the olecranon-ulnar styloid linescattered Scattered-point likely. There is a constant perforator artery in the site8.95±1.33cm of medial epicondyle and the diameter is0.73±0.06mm, so it canbe selected as vascular pedicle.The perforator arteries chain-like arrange in the ulnar forearm andcoincide with each other forming a network to supply skin. And form ulnarforearm subcutaneous vascular network (chain). The axis line of the network isolecranon-ulnar styloid line, and measure the blood supply area of the ulnarsubcutaneous arterial network, the proximal range is30.75mm apart from Epitrochlear-lateral condyle humerus and the distal range is29.3mm from theulnar styloid horizontal.Conclusion:Through micro-anatomy study of10side, five cases of fresh adult upperlimb, we can identify the position of perforator arteries in the forearm ulnar, thenumber of branches, pedicle length, the distribution of branched-network, theanastomosis under subcutaneous and blood supply range. The perforator arteryof Ulnar forearm located on both sides of the olecranon-ulnar styloid linescattered Scattered-pointlikely. There is an constant perforator artery in the site8.95±1.33cm of medial epicondyle and the diameter is0.73±0.06mm, so it canbe selected as vascular pedicle.Choose this perforator artery as rotation point,the olecranon-ulnar styloid as axis line, the middle of the ulnar forearm assupply tissue, through the subcutaneous arterial network, we can cut flap awayfrom the axis line3.0±1.3cm to design perforator flap of ulnar forearm. Thestudy provides anatomical accordance for scientific design and clinicalapplications. This research provide a new repair of soft tissue defects method ofsimple operation, hidden for the supplying District, without sacrificing a majorartery, ease of clinical promotion.