ANATOMY STUDY ON MICRO TRANSVERSE FLAP PEDICLED WITH SUPERFICAL PALMAR BRANCH OF RADIAL ARTERY FROM PALMAR WRIST_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

1Department of Upper Limber Surgery, Beijing Shunyi Hospital of China Medical University, Beijing, 101300, P.R.China;;
2Department of Hand Surgery, the Third Hospital of Hebei Medical University;;
3Department of Anatomy, Capital Medical University Yanjing Medical College. Corresponding author: WU Jinying, E-mail: myhand699@yahoo.com.cn;

Corresponding author：

Keywords：

Superficial palmar branch of the radial artery; Transverse flap of palmar wrist; Free grafting Microdissection

DOI：

10.7507/1002-1892.20130189

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Objective To study the anatomical basis of micro transverse flap pedicled with the superfical palmar branch of radial artery from the palmar wrist for using this free flap to repair soft tissue defect of the finger. Methods Thirty-eight fresh upper limb specimens (22 males and 16 females; aged 26-72 years with an average of 36 years; at left and right sides in 19 limbs respectively) were dissected and observed under operating microscope. Two specimens were made into casting mould of artery with bones, and 2 specimens were injected with red emulsion in radial artery. Thirty-four specimens were injected with 1% gentian violet solution in the superfical palmar branch of the radial artery. A transverse oval flap in the palmar wrist was designed, the axis of the flap was the distal palmar crease. The origin, distribution, and anastomosis of the superfical palmar branch of the radial artery were observed. Results The superficial palmar branch of the radial artery was constantly existed, it usually arises from the main trunk of the radial artery, 1.09-3.60 cm to proximal styloid process of radius. There were about 2-5 branches between the origin and the tubercle of scaphoid bone. The origin diameter was 1.00-3.00 mm, and the distal diameter at the styloid process of radius was 1.00-2.90 mm. The venous return of flap passed through 2 routes, and the innervations of the flap mainly from the palmar cutaneous branch of the median nerve. The area of the flap was 4 cm × 2 cm-6 cm × 2 cm. Conclusion The origin and courses of the superficial palmar branch of the radial artery is constant, and its diameter is similar to that of the digital artery. A transverse oval flap pedicled with the superfical palmar branch of radial artery in the palmar wrist can be designed to repair defects of the finger.

Citation： ZHAO Min,TIAN Dehu,SHAO Xinzhong,LI Dacun,LI Jianfeng,LIU Jingda,ZHAO Liang,LI Hailei,WANG Xiaolei,ZHANG Wentong,WU Jinying,YUAN Zuoxiong. ANATOMY STUDY ON MICRO TRANSVERSE FLAP PEDICLED WITH SUPERFICAL PALMAR BRANCH OF RADIAL ARTERY FROM PALMAR WRIST. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(7): 864-868. doi: 10.7507/1002-1892.20130189 Copy

1.	Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
2.	Yang JW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
3.	周晓, 芮永军, 许亚军, 等. 大鱼际微型穿支皮瓣在拇指近节指挛缩修复中的应用. 中国修复重建外科杂志, 2012, 26(11): 1405-1406.
4.	林崇正, 柴益民, 王和驹, 等. 逆行桡动脉掌浅支蒂大鱼际岛状皮瓣的临床应用. 中华显微外科杂志, 2002, 25(3): 221-222.
5.	赵英波, 侯书健. 桡动脉掌浅支为蒂的大鱼际皮瓣的显微外科解剖. 中国临床解剖学杂志, 2010, 28(3): 245-247.
6.	李锦荣, 李浪, 许亚军, 等. 吻合血管的大鱼际皮瓣移植修复手指软组织缺损. 中华显微外科杂志, 2005, 28(2): 127-129.
7.	Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
8.	Lee TP, Liao CY, Wu LC, et al. Free flap from the superficial palmar branch of the radial artery (SPBRA flap) for finger reconstruction. J Trauma, 2009, 66(4): 1173-1179.
9.	Sassu P, Lin CH, Lin YT, et al. Fourteen cases of free thenar flap: a rare indication in digital reconstruction. Ann Plast Surg, 2008, 60(3): 260-266.
10.	Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar aera of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
11.	Noh SM, Kim JS, Lee DC, et al. Reconstruction of soft tissue defect of the finger with thenar free flap. J Korean Soc Plast Reconstr Surg, 2008, 35(6): 450-454.
12.	Kim KS, Kim ES, Hwang JH, et al. Thumb reconstruction using the radial midpalmar (perforator-based) island flap (distal thenar perforator-based island flap). Plast Reconstr Surg, 2010, 125(2): 601-608.
13.	Omokawa S, Tanaka Y, Ryu J, et al. Anatomical consideration of reverse-flow island flap tuansfer from the midpalm for finger reconstruction. Plast Reconstr Surg, 2001, 108(7): 2020-2025.
14.	Omokawa S, Tanaka Y, Shigematsur K, et al. Reverse-flow island flap from the thenar area of the hand. J Reconstr Microsurg, 2002, 18(8): 659-664.
15.	王友华, 汤锦波, 成红兵, 等. 带血管神经蒂的大鱼际近端皮瓣修复指腹缺损. 中华手外科杂志, 2001, 17(4): 206-208.
16.	孙战胜. 薄型皮瓣修复手部外伤后软组织缺损. 中国修复重建外科杂志, 1997, 11(6): 353-355.
17.	周晓, 许亚军, 芮永军, 等. 拇指桡侧指动脉关节皮支为蒂岛状皮瓣的临床应用. 中国修复重建外科杂志, 2011, 25(9): 1036-1039.
18.	郭建欣, 石法亮, 王萌, 等. 鱼际穿支动脉岛状皮瓣修复拇指指腹缺损. 实用手外科杂志, 2004, 18(2): 75-76.
19.	庞有明, 丰波, 张雪雁, 等. 大鱼际逆行岛状皮瓣的血管解剖及临床应用. 中国冶金工业医学杂志, 2012, 29(4): 377-379.
20.	李文庆, 王钢, 徐达传, 等. 大鱼际皮瓣的解剖学基础及临床应用. 中国临床解剖学杂志, 2007, 25(2): 217-220.

1. Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg, 1993, 92(7): 1380-1384.
2. Yang JW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg, 2010, 26(8): 529-538.
3. 周晓, 芮永军, 许亚军, 等. 大鱼际微型穿支皮瓣在拇指近节指挛缩修复中的应用. 中国修复重建外科杂志, 2012, 26(11): 1405-1406.
4. 林崇正, 柴益民, 王和驹, 等. 逆行桡动脉掌浅支蒂大鱼际岛状皮瓣的临床应用. 中华显微外科杂志, 2002, 25(3): 221-222.
5. 赵英波, 侯书健. 桡动脉掌浅支为蒂的大鱼际皮瓣的显微外科解剖. 中国临床解剖学杂志, 2010, 28(3): 245-247.
6. 李锦荣, 李浪, 许亚军, 等. 吻合血管的大鱼际皮瓣移植修复手指软组织缺损. 中华显微外科杂志, 2005, 28(2): 127-129.
7. Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1420.
8. Lee TP, Liao CY, Wu LC, et al. Free flap from the superficial palmar branch of the radial artery (SPBRA flap) for finger reconstruction. J Trauma, 2009, 66(4): 1173-1179.
9. Sassu P, Lin CH, Lin YT, et al. Fourteen cases of free thenar flap: a rare indication in digital reconstruction. Ann Plast Surg, 2008, 60(3): 260-266.
10. Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar aera of the hand: its surgical applications. Plast Reconstr Surg, 1997, 99(1): 116-121.
11. Noh SM, Kim JS, Lee DC, et al. Reconstruction of soft tissue defect of the finger with thenar free flap. J Korean Soc Plast Reconstr Surg, 2008, 35(6): 450-454.
12. Kim KS, Kim ES, Hwang JH, et al. Thumb reconstruction using the radial midpalmar (perforator-based) island flap (distal thenar perforator-based island flap). Plast Reconstr Surg, 2010, 125(2): 601-608.
13. Omokawa S, Tanaka Y, Ryu J, et al. Anatomical consideration of reverse-flow island flap tuansfer from the midpalm for finger reconstruction. Plast Reconstr Surg, 2001, 108(7): 2020-2025.
14. Omokawa S, Tanaka Y, Shigematsur K, et al. Reverse-flow island flap from the thenar area of the hand. J Reconstr Microsurg, 2002, 18(8): 659-664.
15. 王友华, 汤锦波, 成红兵, 等. 带血管神经蒂的大鱼际近端皮瓣修复指腹缺损. 中华手外科杂志, 2001, 17(4): 206-208.
16. 孙战胜. 薄型皮瓣修复手部外伤后软组织缺损. 中国修复重建外科杂志, 1997, 11(6): 353-355.
17. 周晓, 许亚军, 芮永军, 等. 拇指桡侧指动脉关节皮支为蒂岛状皮瓣的临床应用. 中国修复重建外科杂志, 2011, 25(9): 1036-1039.
18. 郭建欣, 石法亮, 王萌, 等. 鱼际穿支动脉岛状皮瓣修复拇指指腹缺损. 实用手外科杂志, 2004, 18(2): 75-76.
19. 庞有明, 丰波, 张雪雁, 等. 大鱼际逆行岛状皮瓣的血管解剖及临床应用. 中国冶金工业医学杂志, 2012, 29(4): 377-379.
20. 李文庆, 王钢, 徐达传, 等. 大鱼际皮瓣的解剖学基础及临床应用. 中国临床解剖学杂志, 2007, 25(2): 217-220.

Chinese Journal of Reparative and Reconstructive Surgery

ANATOMY STUDY ON MICRO TRANSVERSE FLAP PEDICLED WITH SUPERFICAL PALMAR BRANCH OF RADIAL ARTERY FROM PALMAR WRIST

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