Anatomic basis of the proximal ulnar artery perforator neurocutaneous flap

Objective To provide anatomic basis for clinical application of the neurocutaneous flap pedicled with proximal ulnar artery perforator.Methods 30 embalmed upper limbs from adult cadavers perfused with red latex were used for this anatomic study,and the followings were observed: ①The course and distribution of the medial forearm cutaneous nerve.②Aanastomoses between the proximal ulnar artery perforator and nutrient vessels of medial forearm cutaneous nerve.③Mimic operation was performed on one fresh specimen.Results ① Anterior branch of the medial forearm cutaneous nerve(MFCN),with the relative large diameter,companied with basilic vein and coursed through superficial fascia located in flexor carpi ulnaris and palmaris longus.The MFCN distributed on medial forearm and distally reached transverse striation of the wrist.②The nutrient vessels of MFCN were plurisegmental and polyphyletic.The proximal ulnar artery perforator is more constant,originated from ulnar artery,passed through flexor digitorum superficialis and flexor digitorum profundus,coursed down between flexor digitorum superficialis and flexor carpi ulnaris,and left deep fascia into subcutaneous tissue below the internal epicondyle of humerus about 8.7cm.And then proximal ulnar artery perforator gave off many small vessels,which anastomised with those nutrient vessels of medial forearm cutaneous nerve,and formed a vascular plexus followed with medial forearm cutaneous nerve between flexor digitorum superficialis and flexor carpi ulnaris.The proximal ulnar artery perforator was about(2.0±0.2) cm in length,and(0.9±0.2) mm in the diameter.Conclusions The proximal ulnar artery perforator neurocutaneous flap can be performed to repair defects around elbow joint.