Upgrade Snuffbox Flap Anatomy Study And Clinical Application

Background:With the life of the people of mechanical, electrical and other products increased, hand injuries are also becoming a common multiple injuries.A larger area of skin defect of hand in serious hand injuries and hand injuries in the destruction of the more common, not handled properly will seriously affect the injured hand, wrist appearance and function of. Application of other parts of the body flap (such as:the abdomen, groin and season ribs flap) to eliminate the hand wound, although the procedure easy to operate. The risks were low, but patients with a special position because of the need Limbs brake 3 weeks, and the need for second surgery pedicle, has brought great suffering for patients and a lot of inconvenience. Significantly increased the care, treatment difficulty, length of stay. Pedicled skin flap with more and more used in clinical,surgical methods are becoming increasingly sophisticated. Traditional snuffbox flap, mainly used in large tiger's mouth opened and skin defects, rotation point is located in the central snuffbox, while the improved snuffbox flap rotation point is located at the radial styloid process, for the hand wrist radial skin and soft tissue defects increased the range of flap repair, and the flap blood supply can be guaranteed to overcome the shortcomings of distal flaps, are yet to see the relevant literature.Objective:The experimental observation of the superficial radial nerve in the snuff nest area and take the line's proximity with the cephalic vein;the superficial radial nerve in the snuff nest area and take the line's proximity with the cephalic vein; Radialartery Snuffbox form paragraph;Recurrent branch of radial styloid process of radius styloid process from the initial dot pitch;As the basis to explore the application of improved treatment of carpal Snuffbox hand flap of skin and soft tissue defects of the radial side of the surgical method.Methods:Conventional fixed with formalin into the corpse of 40-side upper hand specimens (18 males,2 females), some with red latex perfusion, anatomy and observation of the first conventional vein, the adjacent superficial radial nerve conditions; superficial radial nerve support branching and variation; radial artery segment of the form snuff nest. Vernier caliper with radial nerve superficial branch points inside and outside the office to the radial styloid process of collateral distance; radial artery nasopharyngeal fossa length, proximal end and distal end diameter, constant measurement of the arterial branch and the dorsal carpal branch of dorsal artery of thumb Point of distance from the radial styloid process; styloid recurrent branch of radial artery radial styloid process from the initial dot pitch. And on this basis, the radial styloid process design for the rotation point improvement Snuffbox flap, the clinical treatment of radial wrist hand 18 cases of skin and soft tissue defects.Results:Superficial radial nerve at the radial styloid process,on 5.14±0.12cm punishment for the internal and external collateral, not found in three, mutations with the radial artery snuff fossa length was 2.50±0.18cm, the proximal end and distal end of outer diameter was 2.60±0.10mm, and 2.20±0.13mm. The section of constant branch of the radial artery and dorsal carpal branch of dorsal artery of the thumb, dorsal carpal branch of ulnar own dry, radial styloid process at the bottom of 1.20±0.11cm Department issued; thumb dorsal artery in the lateral wall of the artery in radial styloid process issued under the 1.50±0.12cm Department. The two issued a high degree of branching than constant. Recurrent branch of radial styloid process of radius styloid process of the starting dot pitch distance of 1.20±0.20cm, the constant support given. To the anatomical structure as the basis for the rotation point of the radial styloid process improvement Snuffbox flap design and clinical treatment of wrist and hand skin and soft tissue defect of the radial side of the 18 cases, all flaps survived,1 patient had a remote part of the epidermal necrosis, healed after changing dressing, soft skin, good blood circulation.Conclusion:The upgrade snuff-box flap can be maded easily with a bundant blood,good sensation,and aviod the second reshaping operations. So it was perfecter and simple surgical procedure for the repair of soft tissue defect in radialis wrist-hands than tradition procedure...