| Objective: High frequency color Doppler ultrasound was used to study the distribution and hemodynamic parameters of the superficial palpal branch of the transverse radial artery of the wrist,and to understand the course,distribution and ultrasonic characteristics of the superficial palpal artery.Methods: The superficial palpal branch of bilateral radial artery was examined by high frequency color Doppler ultrasound in 100 healthy volunteers,and the superficial palpal branch of transverse carpal artery was searched for the perforating branch of the superficial palpal branch of radial artery,and the course of the perforating branch of superficial palpal branch of radial artery was determined.The branch points of the superficial palpal branch of the radial artery were marked,the diameter of the vessel was measured,the hemodynamic parameters were detected,the static images were stored,the parameters were recorded,and the parameters were compared between the left and right hands and different genders.Result: There were 200 strips of Color Doppler ultrasonography radial artery,198 strips of Brachial artery whose detection rate was 99%,the distance between Brachial artery and Scaphoid was(1.3±0.55)cm among of them,however,there were 5 branches of the superficial branch of the radial artery,which were about(2.5±0.45)cm away from Scaphoid.Two cases of one side of the radial artery had a short branch,and there one male and one female were left-handed.Comparison of left and right hands,right hand blood flow was higher than left hand,but there a statistical difference of the comparison of blood flow between the left and right hands was P<0.05.Comparison of male and female,male blood vessel diameter was higher than female and its statistical difference of the comparison of blood vessel diameter between male and female was P<0.05,male blood flow was higher than female together with the statistical difference of the blood flow between male and female was P<0.05.Conclusion: First,high-frequency color Doppler ultrasound can real-time monitor the superficial metacarpal perforating branch of the transverse carpal striated radial artery,and accurately locate the branches of the superficial metacarpal perforating branch of the transverse carpal striated radial artery.The structure and hemodynamics of the perforating branch of the superficial metacarpal branch of the transverse carpal striated radial artery can be accurately evaluated.Second,the distance from scaphoid bone to scaphoid by 97.47% of the perforating branch of superficial metacarpal branch of transverse carpal striated radial artery in normal subjects(1.3 ±0.55)cm;There were variations in the superficial metacarpal branch of the transverse carpal striated radial artery and the distance from the scaphoid bone between the superficial metacarpal branch of the transverse carpal striated radial artery and the scaphoid bone.The variation rate of the high branch was 2.52%.The unilateral absence of the superficial metacarpal branch of the radial artery of the carpal transverse striae in normal subjects was 1%(1%),all of which were left-handed.Third,the diameter and blood flow of the perforating branch of the superficial metacarpal branch of the radial artery in the transverse striated radial artery of the wrist were higher in the male than in the female.Objective: To evaluate the value of selecting and cutting the flap according to the high-frequency color Doppler ultrasound before the finger injury repair and positioning of the brachial artery.Methods: Between August 2016 and March 2017,25 patients were scheduled to operate finger repair surgery with the application of radial brachial artery who were hospitalized in our Hand and foot surgery hospital due to hand tissue defect,among of them,there were 22 males,3 females whose age ranged from 16-48 years old and the average age was 34.3 years old.Before the operation,high-frequency color Doppler ultrasound was used to detect the brachial artery which was in order to understand the existence of perforator,out of the point,distance from the scaphoid nodule,diameter,hemodynamics and other information together with guiding flap design and cutting,then compared with the actual measurement of intraoperative perforating blood vessels,counted the success rate of surgery and the survival rate of flaps from 7 months to 1 year after surgery.Moreover,exploring the basis of high-frequency color Doppler ultrasound was selected to the appropriate percutaneous radial artery perforating vessels,and compared with the preoperative and intraoperative detection results for significant differences.Result: There were 25 patients positioning 27 branches of the radial artery in total with application of Color Doppler ultrasound,among of them,there 1 branch of the radial artery with a branch of the iliac artery was about 0.6-0.8cm away from the scaphoid,3 branches of Brachial artery were distributed 0.8-1.0cm from Scaphoid,20 branches of the radial artery of the iliac artery were transmitted 1.0-1.5cm from the scaphoid nodule,2 branches of the radial artery of the iliac artery were distributed 1.5-2.0cm from the scaphoid and there 1 branch of the radial artery had a high branch variation which were transmitted 2.1cm from the scaphoid nodule.In preoperative exploration,27 perforating vessels with an inner diameter was(1.05±0.33)cm,blood flow velocity was(14.94±4.39)cm/s and blood flow was(0.97±0.31)cm together with the intraoperative actual measurement of the diameter of 27 perforating vessels which was(0.97±0.31)cm.Comparison of preoperative ultrasound detection of perforating vessels with real-time intraoperative conditions,there was no significant difference between them(P>0.05).What’s more,repairing of hand tissue defected in 25 patients with brachial sacral artery and superficial perforator flap together with transplanting flaps survived successfully with a success rate of 100% and the flap survival rate was 100% after 7-12 months of follow-up,and the function recovered well and the appearance was good.Conclusion: The application of high-frequency color Doppler ultrasonography was to locate the perforating vessels of the superficial temporal artery flap of the radial artery and assessed the inner diameter and hemodynamics of the vessel which could provide an important basis for the design and cutting of the perforator flap.Preoperative use of high-frequency color Doppler ultrasonography to detect the presence of perforating vessels was a prerequisite for surgical outcomes,before transplantation the size of the perforating vessel diameter was the primary consideration,the success of the anastomosis of the blood vessels was important and how much blood flow through the branch was closely related to flap survival.However,determining the distance from the perforating vessel to the scaphoid nodule and accurately locating the position where the flap was to be cut can effectively avoid unnecessary incision length and secondary damage together with providing accurate basis for preoperative individualized design and operation of flap transplantation,therefore,laying the foundation for the success of flap transplantation. |
