Abstract：
PURPOSE OF THE STUDY The study aimed to propose an optimal based fl ap creation with the view to ensure long-term survival of the interposition arthroplasty. MATERIAL AND METHODS A total of 28 dorsal wrist capsules were collected from 16 cadavers (with age range at death 18 to 80 years, with no visible wrist pathology). Altogether 112 histological specimens were obtained from these 28 samples. Post-hoc Dunn\'s tests were used to analyse the percentage of vascularisation of individual sides of the dorsal capsule (circumference and area) at the 0.05 level of signifi cance. Spearmann\'s correlation analysis was used to assess the effect of age on vascularization of the dorsal wrist capsule. In cadavers in whom both capsules were collected, the limbs were compared. For the sake of comparison, the Wilcoxon matched pairs test was used. RESULTS Regarding statistical signifi cance, the largest share of the total circumference and area of the measured vessels of the dorsal capsule is constituted by the distal side (35.2% of the circumference and 30.9% of the area). The blood supply of the dorsal capsule received on the ulnar side is the lowest (12.9% of the circumference and 17.6% of the area). There was no signifi cant effect of age on vascularization of the dorsal wrist capsule confi rmed. Also, the comparison of vascularization of both limbs from a single cadaver did not yield any statistically signifi cant results. DISCUSSION Proximal row carpectomy is a long-established surgical technique used to manage the degenerative changes in the wrist. Our results showed the best vascularization on the distal and radial sides of the dorsal wrist capsule. In this light, the distally-based fl ap or the fl ap described by Berger, which respects the clinically important ligaments, appear to be the least invasive and help maintain the future stability of the wrist. CONCLUSIONS In clinical practice, we advise that a radially-based fl ap according to Berger is created and the distal side of the dorsal capsule, the most vascularized portion based on our results, is preserved as much as possible. The fl ap created in this manner also preserves the important carpal ligaments and appears to the authors of this study to be the most benefi cial, also with respect to the presence of the largest arteries, contrary to the distal side. Another option is to use a distally-based fl ap for interposition arthroplasty. Key words: interposition arthroplasty, proximal row carpectomy, vascularization, degenerative changes, wrist.
摘要：
研究目的该研究旨在提出一种最佳的基于flap的创建方法，以确保间置关节成形术的长期生存。材料与方法从16具尸体（死亡年龄在18至80岁，没有可见的手腕病理)。从这28个样品中总共获得112个组织学标本。Post-hocDunn\'stestswereusedtoanalyzethepercentageofvascularisationoftheinderalsideofthedorsalcapsulationoftheseriouscapsulationofthedorsalsideofthedorsalcapsulation(周长和面积).采用Spearmann相关分析评估年龄对腕关节背囊血管形成的影响。在收集了两个胶囊的尸体中，四肢进行了比较。为了比较,使用Wilcoxon配对检验.结果关于统计显著性，背囊测量血管的总周长和面积的最大份额由远端构成（周长的35.2％和面积的30.9％）。尺侧接收的背侧囊的血液供应最低（周长的12.9％和面积的17.6％）。年龄对腕背囊血管化没有明显影响。此外，单具尸体的双肢血管化比较未产生任何统计学意义的结果.讨论近端行腕管切除术是一种长期建立的手术技术，用于处理腕部的退行性变化。我们的结果表明，腕背囊的远端和radial侧的血管形成最好。在这种情况下，基于远端的flap或Berger描述的flap，尊重临床上重要的韧带，似乎是侵入性最小的，有助于保持手腕的未来稳定性。结论在临床实践中，我们建议根据Berger创建一个基于径向的flap，并且背囊的远侧，根据我们的结果，血管化程度最高的部分，尽可能地保存。以这种方式创建的flap也保留了重要的腕骨韧带，并且在本研究的作者看来是最有益的，还有最大动脉的存在，与远端相反。另一种选择是使用基于远侧的flap进行插入关节成形术。关键词:间位关节成形术,近排腕管切除术,血管化,退行性变化，手腕。
