The Anatomy And Clinical Application Of The Free Flap Of The Epithelial Carpal Branch Of The Ulnar Artery To Repair Finger Soft Tissue Defects

PART 1 ANATOMICAL STUDY OF FREE SUPRAMAXILLARY ULNAR ARTERY FLAP FOR REPAIR OF SKIN AND SOFT TISSUE DEFECTS OF FINGERSObjective:Six fresh adult cadavers were dissected,To provide a systematic anatomical basis for the free supracarpal ulnar cutaneous branch flap pedicled with the supracarpal ulnar artery.Methods :Six fresh adult upper limb specimens will be selected,Red latex was injected after arterial intubation,After skin incision,The ulnar artery and its branches were dissected and exposed carefully,The position,origin,course,branch,pedicle length,venous,nerve and flap blood supply were observed,The measured data were analyzed with SPSS22.0 software,the means were espressed as(?x±s),The excision and transplantation of the free supracarpal ulnar cutaneous branch flap pedicled with the supracarpal ulnar artery were simulated in the specimen.Results:In this study,a specimen of ulnar artery was found to have a variation of the supraspinal cutaneous branch,ulnar artery supraspinal cutaneous branches were found in all other specimens,above the pea bone(3.8±0.6)cm comes from the ulnar artery,it runs below the ulnar flexor carpi carpi,the starting diameter is(1.4±0.3)mm,vascular pedicle length is(1.2±0.1)cm,the ulnar artery is divided into the ascending branch and the descending branch,the two accompanying veins of the ulnar artery wrist cutaneous branch and the forearm valuable veins are good choices for the venous reflux of the ulnar artery wrist cutaneous branch,the ulnar skin of the forearm is supplied by the medial forearm cutaneous nerve,The medial cutaneous nerve of the forearm can be resected as the sensory nerve of the flap.Conclusions :The anatomy of the cutaneous branch of the ulnar artery on the wrist was relatively constant and Less variation,The suprachipal cutaneous branch of ulnar artery can be used as the pedicle to repair the small and medium soft tissue defects of fingers.PART 2 CLINICAL APPLICATION OF FREE SKIN FLAP OF ULNAR ARTERY WRIST BRANCH IN REPAIRING FINGER SOFT TISSUE DEFECTObjective:to investigate the clinical effect of free supraspinal ulnar artery skin flap pedicled with supraspinal ulnar artery.Methods :Seven patients with finger soft tissue defects in June 2016 and December 2018 were selected,the free flap pedicled with the ulnar artery wrist branch was used for repair.Results :Postoperative follow-up was 6-12 months,all the flaps survived in 7 cases,In 1 case,the distal part of the flap was necrotic and healed after skin grafting,The flap texture and appearance were satisfactory,no obvious bloat,similar to the finger receptor,no need for a second plastic surgery,the donor area heals well,only linear scars were left.Conclusion :The free supracarpal ulnar cutaneous branch flap pedicled with the supracarpal ulnar artery is relatively simple and safe to operate,It does not damage the main blood vessels of the forearm,the flap has good texture and elasticity.The difference between skin color of skin flap and skin color of fingers was not big,the donor area is less damaged,so it is suitable for repairing the skin and soft tissue defect of fingers.the operation can be performed on the same side,and the operation can be completed in one stage,no need for a second break,can carry out functional rehabilitation exercise early,shorten the treatment cycle,reduced the incidence of joint stiffness,beneficial to the recovery of finger movement,postoperative finger appearance was satisfactory,after carrying the nerve,it can restore the sensation of the injured finger,It is an ideal way to repair the skin and soft tissue defect of fingers.