Clinical anatomy of the medial upper arm flap pedicled with different cutaneous vessels

Objective: To provide anatomic basis for clinic application of the medial upper arm flap. Methods: In 18 sides of adult upper fresh specimen perfused red emulsion into common carotid artery, the distribution of blood vessels of the medial upper flap was observed. Results:(1)The superior ulnar collateral artery was the first choice as the pedicled vessel for its wide caliber and the long course.(2)There were compensatory relations among cutaneous branches of superior, inferior ulnar collateral artery and brachial artery. The cutaneous branches of the inferior ulnar collateral artery and brachial artery can be designed as the pedicled vessels if the superior ulnar collateral artery was absent.(3)Cutaneous branches of the medial upper arm flap appeared as the shape of 人 . In the inferior part of medial upper arm, cutaneous branches of inferior lunar collateral artery and brachial artery located at the front of the myoseptum, and gradually coursed anteriorly. However, the cutaneous branches of the superior collateral artery coursed at the back of the myoseptum, and gradually passed posteriorly. Therefore, the skin flap should be removed anteriorly and posteriorly when taking inferior and superior ulnar collateral arteries as the pedicled vessels respectively. Conclusions: The medial upper arm flap pedicled with superior ulnar collateral artery is desirable, otherwise, cutaneous branches of the inferior ulnar collateral artery or brachial artery can be taken as the substitutes.