Applied Anatomy Study Of Island Flap Pedicled With Cutaneous Nerve Of Arm And Its Concomitant Vessels

Objective To provide the applied anatomic basis for the application of island flap pedicled with the cutaneous nerve of arm and its concomitant vessels.Methods The origin ,course ,distribution ,anastomosis and out diameter of cutaneous nerve of brachial and its concomitant vessels were observed on 28 sides adult cadaver specimens perfused with red latex .The relationship between nutrient vessels and the range of blood supply of skin was observe and determined .Results All cutaneous nerve of arm has its concomitant vessels. The superior lateral arm cutaneous nerve originates from the lower ramus of axillary nerve with an external diameter of 1.3±0.5(0.7~2.1)mm, its nutrient vessels originated from the collateral branch of posterior cricumflexa humeri artery with an diameter of 0.8 ± 0.2(0.4~1.2)mm; The inferior lateral arm cutaneous nerve originates from radial nerve with an external diameter of 1.7±0.6(0.7~3.2)mm, its nutrient vessels originated from the collateral muscular branch of collateralis radialis artery with an diameter of 0.8 ±0.3(0.5~1.2)mm; The medial arm cutaneous nerve originates from the medial bundle of brachial plexus with an external diameter of 1.3±0.5(0.7~2.1)mm, its blood supply originated from the superior ulnar collateral artery with a mean diameter of 0.6± 0.3(0.3~1.4)mm; The posterior arm cutaneous nerve originates from radial nerve with a mean external diameter of 1.5 ± 0.4(0.8~2.2)mm, its blood supply originated from the collateral branch of axillary artery and brachial artery with an external diameter of 0.8± 0.2(0.4~1.2)mm. The concomitant vessels anastomosis with its nerve branch which formed rich vessel network among nerve tract or beside the nerve and connected with brachial vessel network by its branches.Conclusion The antegrade or retrograde island flap or free flap could be designed by the four cutaneous nerve and their nutrient vessels to adjacent and hand soft tissue defect.