Applied anatomy of the compound flap of distally based pedicled with nutritional vessels of the lateral cutaneous nerve of forearm and cephalic vein

Objective: To provide anatomic basis for designing compound flap of distally based pedicled with nutritional vessels of the lateral cutaneous nerve of forearm. Methods: The origins,branches and the relationship with periosteum vessels of radius for nutritional vessels of the 1/3 inferior segment of the lateral cutaneous nerve of forearm were observed on 30 adult cadaveric superior limb specimens perfused with red gelatin. Results: The origins of nutritional vessels of the 1/3 inferior segment of the lateral cutaneous nerve of forearm was as follows: the perforating branches of radial artery (6~11 branches) with diameter of (0.7±0.3)mm;superficial palmar branches (2~6 branches) with diameter of (0.5±0.3)mm; perforating branches of radius styloid process return branches (1～2 branches) with diameter of (0.8±0.1)mm; perforating branches of snuff tobacco (1～2 branches) with diameter of (0.6±0.2)mm; the intermuscular spaces perforating branches of radial artery being superior of radius styloid process about 8.0~15.0 cm (1～3 branches) with diameter of (1.1±0.2)mm. Periosteal vessels net distributed to expose of distal-middle radius, the diameter of its cutaneous branches were about 0.8±0.2 mm. Above mentioned perforating branches included fascia branches, cutaneous branches, periosteum branches, nerve and vein nutrition branches. Those nutrient vessels originated from longitudinal vessel chain of the lateral cutaneous nerve of forearm and cephalic vein, deep subcutaneous fascia and periosteum vessel network. Conclusions: The results suggest that the nutrient vessels of the lateral cutaneous nerve of forearm and cephalic vein have homology with the nutrient vessels of muscles, bone and skin. The distally-based flap (periosteum) pedicled with the cutaneous branches of radial artery with the rotation point at the wrist joint can be applied to repair soft tissues defect of the hand distant parts.