Anatomic Study of the Distally Based Island Flap with Nutrient Vessel from Basilic Vein and Cutaneous Nerve in Ulnar Forearm

Objective To provide the anatomic basis for designing island flap, with nutrient vessel of the basilic vein-cutaneous nerve of ulnar forearm. Methods The origin, branches and the relationship with periosteum vessels of ulnar of the nutritional vessels for basilic vein-medial antebrachial cutaneous nerve were observed on 30 adult forearm specimens, perfused with red emulsion in the artery. Results The origins of nutrient vessel of the 1/3 inferior segment of the basilic vein-medial antebrachial cutaneous nerve was as follows: the cutaneous branches of ulnar artery(5～9 branches) and the cutaneous branches of ulnar artery of upper wrist (1～3 branches) with external diameter of 0.4～1.2 mm. It's located in the position between 6.0～16.0 cm upper of ulnar styloid process, the bone cutaneous perforating branches of anterior artery had 2～3 branches and the bone cutaneous perforating branches of posterior interosseous artery had 1～3 branches with external diameter of 0.4～1.2 mm, bone cutaneous perforating branches distributed to periosteal of distal-middle ulnar and the skin of corresponding area. Perforating branches includes fascia branches, cutaneous branches, nerve and vein nutrition branches. Those nutrient vessels form a longitudinal vessel chain of the cutaneous nerve of forearm-basilic vein, deep subcutaneous fascia and periosteum vessel network. Conclusion The results suggested that the nutrient vessels of the basilic vein of ulnar margin of forearm and cutaneous nerve are homologious to the nutrient vessels of muscles, bone and skin. The flap of distally-based pedicled with the dorsal carpal branches of ulnar artery with the rotation point at the wrist joint can be applied to repair the defect of the hand.