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目的:为带旋肱前动脉外侧降支为蒂的肱骨上段外侧面骨膜瓣移位术提供解剖学依据。方法:在38 侧经动脉灌注红色乳胶的成人上肢标本上对旋肱前动脉外侧降支的来源、走行、分布进行了解剖学观测,并在4 侧标本上摹拟手术实验。结果:旋肱前动脉经喙肱肌和肱二头肌短头深面,绕肱骨外科颈外进至结节间沟外侧缘分别分出升支和降支。升支上行分布于肱骨头和小结节部。降支有2 条分别沿胸大肌止腱内、外侧紧贴骨膜下行,为内侧降支和外侧降支。外侧降支下行分布于肱骨上段外侧面三角肌前部所覆盖区。结论:以旋肱前动脉外侧降支为蒂的肱骨上段外侧骨膜瓣移位可用于修复肱骨头缺血性坏死和肱骨近端骨不连或小范围骨缺损。
OBJECTIVE: To provide anatomic evidence for the displacement of the lateral humerus periosteal flap pedicled with the descending branch of the anterior humerus artery. Methods: The origin, course and distribution of descending anterior branch of the anterior humeral artery were observed on the 38 sides of the adult upper limbs with arterial infusion of red latex. Simulations were performed on 4 sides. Results: The anterior humeral ankle brachii muscle and biceps brachii short head deep, around the neck of the humerus surgical access to the outer edge of the inter-nodular ascending branch and descending branch. Ascending branches distributed in the humeral head and small nodules. Descending branch there are two along the pectoralis major tendon tendon, lateral close to the periosteum, the medial descending branch and the lateral descending branch. Lateral descending branch down in the upper humeral lateral deltoid muscle covered area. CONCLUSIONS: The displacement of the lateral periosteal flap of the upper humerus pedicled with the descending branch of the anterior humeral artery can be used to repair the humeral head avascular necrosis and proximal humerus or nonsurgical bone defect.