The Anatomy Of The Perforator Of The Forearm

Objective There is a dearth of detailed published work on the anatomy of forearm perforators. This study was undertaken to evaluate the anatomical basis of the forearm perforator flaps and to provide anatomical landmarks to facilitate flap elevation.Methods The forearm perforators were studied in25fresh cadavers and10cast preparations. Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture, selected for3-dimensional reconstruction using special software (MIMICS) and the arterial territory measured with Scion Image. Other ten were injected with red latex preparation, and perforators were identified through dissection. The origin, course, and distribution of the perforators in the forearm region were comprehensively documented.Results The radical and ulnar arteries and the anterior and posterior interosseous arteries supply the forearm, with constant sizable perforators located in the proximal and distal region. The brachial, radical and ulnar arteries send collateral and recurrent arteries to the elbow joint. The anterior interosseous artery springs out dorsal perforator to the dorsal area on the radical part of distal forearm. The ulnar artery gives rise to several perforators that anastomose each other to form a vascular network to supply the ulnar part of forearm. The radical vascular network supplies the radical part. While, the anterior and posterior interosseous arteries give dorsal perforating branches that communicate with each other to supply the dorsum of the forearm.Conclusions These constant sizable perforators of the ulnar and radical arteries provide vascular supply to free flaps. Due to the longer pedicles, these arteries can also provide vascular supply to pedicle flaps to repair the wrist and hand defects. All of the vascular networks of the forearm are alternative for free flaps, pedicle flaps or pressurization vent flaps in clinical treatment.