Anatomical Study Of The Latissimus Dorsi Compound Flap Reconstruction Of Upper Extremity Motor Function

Objective:Explore ways to strengthen the distal latissimus dorsi and the muscle close to latissimus dorsi which can be in coordination with its reconstruction of upper limb function, provide anatomical basis for the latissimus dorsi composite flap reconstruction of upper limb motor function.Methods:Anatomy of 16 sides of 10% formalin fixed adult cadavers, observed the Anatomical relationship between the distal latissimus dorsi and the surrounding muscle, observed the blood vessel and nerve which Penetrate distal latissimus dorsi. Observed the morphology, artery, nerve and location relations of the latissimus dorsi between serratus anterior muscle.Statistical software used spss13.0 statistics.Results:Latissimus dorsi distal aponeurosis surface of the shallow fascia thickness of 19.3±5.69mm, Serratus posterior inferior and erector spinae muscle from the thoracolumbar fascia healing of the surface close, aponeurosis deep to the erector spinae and healing of the superficial thoracolumbar fascia closed,healing the Director of 13.5±3.71cm, width 6.79±2.44cm, aponeurosis thickening to 1.45±0.19mm; Serratus posterior inferior,erector spinae remotely close to the deep surface of latissimus dorsi,blood supply from the intercostal arteries and lumbar arteries, receive the corresponding body section of the dorsal spinal segmental dominance.Distal latissimus dorsi muscle blood vessels, nerve accompanying from undersurface penetrate in the muscle, blood vessels from intercostal artery and lumbar artery, only 1～2 thicker diameter. Dorsal spinal artery penetrated distal latissimus dorsi with a branch of the intercostal or lumbar artery branches. The lower part of the serratus anterior muscle teeth on the level of the 6 to 9 ribs in the Lateral chest wall close to the the latissimus dorsi undersurface; latissimus dorsi and the lower part of the serratus anterior vessels were the same pedicle, received the blood supply from the thoracodorsal artery, Vessel diameter 2.18±0.46mm, vascular pedicle up to 9cm. Latissimus dorsi, serratus anterior muscle innervation independent.Lower serratus anterior muscle angle between teeth, muscle fibers within the tooth to just point to the anterior radial distribution center.Long thoracic nerve in serratus anterior segmental nerves were evident, given downward course of 8 to 10 small, short run in all branches of the serratus anterior muscle disposable tooth.Conclusions:1. Thoracolumbar fascia and thickening of distal superficial fascia of the latissimus dorsi latissimus dorsi compound flap can be enhanced distal tendon structure.2. Serratus posterior inferior, erector spinae and latissimus dorsi inappropriate formation of the latissimus dorsi compound flap used in reconstruction of upper extremity motor function.3. Latissimus dorsi with lower serratus anterior muscle combined flap reconstruction can be applied to upper limb motor function.