前臂是一个有趣的非血管化神经移植的供体部位,尤其是手外科医生.很少有研究描述了外侧和内侧前臂皮神经的使用(LABCN和MABCN,分别)作为血管化神经移植物(VNG)。这项解剖学研究的目的是分析这些神经的特征和血管形成,以描述VNG的新的潜在供体部位。从注射了红色乳胶的新鲜尸体上解剖了十二个前臂。终端分支的数量,长度,研究了LABCN和MABCN的近端和远端直径。还记录了使神经血管化的桡动脉和尺动脉的皮肤穿支动脉的解剖学描述:穿支的数量,长度,穿孔器的类型(隔膜或肌皮),和前臂内的位置(近端,中间,和远端三分之一)。在80%以上的标本中,桡动脉和尺动脉的皮肤穿支动脉使LABCN和MABCN血管化,分别。这些动脉,主要发现于前臂的近端三分之一,直径>0.5mm。其中大多数来自桡动脉和尺动脉(对于LABCN和MABCN血管化,分别)。在超过75%的标本中,两条神经的营养动脉也使浅静脉和皮肤血管化。我们发现这些神经被穿支动脉血管化,也参与静脉和皮肤血管形成。总之,这项解剖学研究表明,重建外科医生可以使用基于前臂穿支动脉的新VNG.
The forearm is an interesting donor site for non-vascularized nerve grafts, especially hand surgeons. Very few studies have described the use of the lateral and medial antebrachial cutaneous nerves (LABCN and MABCN, respectively) as vascularized nerve grafts (VNGs). The aim of this anatomical study was to analyze the characteristics and vascularization of these nerves to describe new potential donor sites for VNGs. Twelve forearms were dissected from fresh cadavers injected with red latex. The number of terminal branches, lengths, and proximal and distal diameters of both the LABCN and MABCN were studied. An anatomical description of the cutaneous perforator arteries from the radial and ulnar arteries that vascularized the nerve was also recorded: number of perforators, length, type of perforator (septo- or musculocutaneous), and location within the forearm (proximal, middle, and distal third). In over 80% of the specimens, the cutaneous perforator arteries from the radial and ulnar artery vascularized the LABCN and the MABCN, respectively. These arteries, found mostly in the proximal third of the forearm, had diameters >0.5mm. Most of them came from the radial and ulnar arteries (for LABCN and MABCN vascularization, respectively). In over 75% of the specimens, the nutrient arteries of both nerves also vascularized the superficial veins and the skin. We found that these nerves are vascularized by perforators arteries, which also participate in vein and skin vascularization. Altogether, this anatomical study shows that reconstructive surgeons could use new VNGs based on the perforator artery of the forearm.