OBJECTIVETo study the distribution of intramuscular nerve and blood vessels in forearm muscles and to discuss the possibility of dividing the forearm muscles into independent functional units.

METHODS(1) The muscles were dissected in 10 forearms from 5 fresh adult human cadavers and stained with the Sihler's nerve staining; (2) The blood vessels were studied in eight forearm muscles from 4 fresh adult human cadavers with irrigation of a mixture of 30% barium sulfate and gelatin from brachial artery and then X-photographed. All pictures were compared to study the intramuscular distribution of nerve and blood vessels.

RESULTSThe intramuscular nerve branches were stained purple-black and visualized clearly. The muscles were classified into three types according to the distribution characters of intramuscular nerve and blood vessels. And the types of muscles could be further subdivided into a and b subtypes.

CONCLUSIONAccording to the neurovascular distribution, the forearm muscles in type II a and type III a can be divided into independent function units for muscle functional transplantation.

Adolescent ; Adult ; Aged ; Female ; Forearm ; blood supply ; innervation ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; blood supply ; innervation ; Young Adult

OBJECTIVETo observe the effects of forearms devascularization on the volt-ampere (V-A) characteristics of Neiguan (PC 6) and Taiyuan (LU 9) so as to investigate the relationship among functions of acupoints, qi and blood in human body and V-A characteristics of acupoints.

METHODSEither forearms of 23 healthy volunteers were devascularized and the changes of V-A characteristics in ipsilateral Neiguan (PC 6) and Taiyuan (LU 9) in normal and devascularization statuses were detected by home-made intelligent V-A detecting system.

RESULTSCompared with the normal status, both range-increasing and range-decreasing V-A areas of Neiguan (PC 6) and Taiyuan (LU 9) were significantly increased in devascularization status (P < 0.05, P < 0.01), and the change rates of these two V-A areas of Neiguan (PC 6) were larger than those of Taiyuan (LU 9) (both P < 0.05). The inertia areas of Neiguan (PC 6) but not Taiyuan (LU 9) became significantly larger after devascularization (P < 0.01).

CONCLUSIONThe changes in V-A characteristics of Neiguan (PC 6) and Taiyuan (LU 9) can reflect the alteration of local blood supply, and Neiguan (PC 6) is more sensitive to changes of blood flow than Taiyuan (LU 9).

Acupuncture Points ; Adult ; Blood Circulation ; Electrophysiology ; Female ; Forearm ; blood supply ; physiology ; Humans ; Male ; Young Adult

BACKGROUND: Blood glucose testing (BGT) at the forearm minimizes the pain experienced during sampling of capillary blood. We compared the BGT results for forearm sampling with those for standard finger skin puncture and venous serum to evaluate the clinical validity of forearm BGT. METHODS: BGT was performed on the finger (G(F)) and forearm (G(A)) with a portable glucometer in 555 subjects, including 61 diabetic patients, under fasting conditions. BGT with venous serum (G(V)) was followed within an hour in 514 subjects. Simple linear regression, intraclass correlation, and Passing-Bablok regression analyses were performed using the G(A)-G(F) and G(A)-G(V) data. RESULTS: G(A) showed an excellent linear relationship with both G(F) and G(V) with a Pearson correlation coefficient (r) of 0.97 (P<0.0001) in the patient group, which was similar to the findings in the normal group except for the lower r values. The mean bias between G(A) and G(F) and between G(A) and G(V) were within +/- 10 mg/dL in both groups. The intraclass correlation coefficients were slightly smaller than the corresponding r values, but they showed the same tendency in both groups. In the Passing-Bablok analyses, the 95% confidence intervals of the slope and intercept parameters were <+/-20% of unity and <+/-20 mg/dL, respectively, which were within the acceptable ranges. All 3 statistical analyses supported the satisfactory agreement of G(A) with G(F) or G(V). CONCLUSIONS: BGT at the forearm was highly consistent with the standard BGT, thereby confirming its applicability in clinical practice for self-testing under steady fasting conditions.
Adult ; Aged ; Blood Glucose/*analysis ; Blood Specimen Collection ; Female ; Fingers/*blood supply ; Forearm/*blood supply ; Humans ; Male ; Middle Aged ; Regression Analysis

OBJECTIVETo explore the possibility that the free latissimus dorsi musculo-cutaneous flap to repair the forearm leg wound.

METHODSTo design latissimus dorsi musculo-cutaneous flap which is foundation on T form thoracodorsal artery stalk. To set the short arm into the receiver artery break and anastomos them. It is not only reassure the blood of free musculo-cutaneous flap, but also reconstruct the continuation of the receiver main artery.

RESULTSIn 16 patients, 15 patients success completely, 1 patient main success. The blood supply of receiver is adequate.

CONCLUSIONSThe free T form thoracodorsal artery stalk musculo-cutaneous flap free grafting is a good method to repair the skin and soft tissues defection of forearm and leg.

Anastomosis, Surgical ; methods ; Arteries ; Forearm ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Leg ; Lower Extremity ; Reconstructive Surgical Procedures ; Skin ; Superficial Back Muscles ; blood supply ; transplantation ; Wound Healing

OBJECTIVETo investigate the applied anatomy of the proximal posterior interrosseous artery perforator flap (PIAP) and report the clinical results of repairing the soft tissue defects in hands.

METHODSBetween September 2007 and January 2011, 21 patients with 24 soft tissue defects in hands were repaired with the free proximal PIAP flap transplantation. The size of the flaps ranged from 2.0 cm x 1.5cm to 7cm x 5cm. The longest length of these flaps was 9 cm. 9 flaps were dissected with one additional superficial vein to anastomose with the superficial vein at the recipient sites.

RESULTS19 flaps survived completely. Bubbles and violet color happened in 4 flaps which survived finally after partial suture removal. Flap necrosis occurred in one flap. The clinical results were satisfactory after 6-25 months of following-up, and the scars at the donor sites were not obvious.

CONCLUSIONSThe free PIAP flaps have constant, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defects in the hands.

Forearm ; Graft Survival ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; blood supply ; transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.

METHODSFrom Oct. 2009 to Oct. 2012, 10 cases of electrical burn wounds on the wrist were treated. A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis. At the midpoint of the line, Doppler flow imaging meter was used to detect the emerging point of perforator vessel. The flap was designed and harvested. The flap was transferred reversely, with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases. The wounds in the donor sites were closed directly in 2 cases, and with skin graft in 8 cases.

RESULTSAll the 10 flaps survived completely. 7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively, which resovled 1 week later. Sub-flap tissue necrosis and infection happened in 2 cases, which healed after dressing and drainage. Patients were followed up for 3-36 months with satisfactory results.

CONCLUSIONSThe middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply. It offers a new choice for the electric burn wound on the wrist, especially at the ulnar side.

Burns, Electric ; surgery ; Forearm ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; blood supply ; transplantation ; Ulnar Artery ; Wrist Injuries ; surgery

OBJECTIVETo investigate the clinical efficacy of carpal branch of ulnar artery skin flap and dorsal carpal branch of anterior interosseous artery skin flap in replantation of complicated severed hand.

METHODSFrom August 1999 to October 2005, 18 patients with complicated severed hands were treated in our department. According to the skin defect of severed hand, the palm of the hand was restored with upper carpal branch of ulnar artery skin flap (2-4 cm x 3-6 cm), followed by restoration of the back of the hand with dorsal carpal branch of anterior interosseous artery skin flap (4-6 cm x 5-8 cm) and replantation of the hand was performed simultaneously.

RESULTSAll the replanted hands and the skip flaps survived after the surgery with satisfactory shape and function. The surgery achieved an over 70% recovery of the hand function in all cases.

CONCLUSIONSFor complicated severed hands, upper carpal branch of the ulnar artery skin flap and dorsal carpal branch of the anterior interosseous artery skin flap are effective to repair the skin defect, and this procedure provides a good option for reconstructing shape and function of the severed hands.

Adolescent ; Adult ; Female ; Forearm ; blood supply ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Replantation ; methods ; Surgical Flaps ; blood supply ; Treatment Outcome ; Ulnar Artery ; surgery

OBJECTIVETo summarize the therapeutic effect of multiple types of posterior interosseous artery flaps for repair of soft tissue defects in the upper extremities.

METHODSFrom March 2003 to June 2010, 42 cases with soft tissue defects in the upper limbs resulting from burn and traumatic injuries were treated using multiple types of posterior interosseous artery flaps, including retrograde flaps and composite flaps, antegrade flaps ,and free flaps. Flap size ranged from 2.5 cm x 2.0 cm-14.0 cm x 9.0 cm. The defects in the donor sites were closed directly or covered by skin graft.

RESULTSThe conventional retrograde posterior interosseous artery flaps were used in 11 cases, the modified retrograde posterior interosseous artery flaps were used in 13 cases, the retrograde posterior interosseous artery composite flaps incorporating partial extensors were used in 2 cases, the antegrade posterior interosseous artery flaps were used in 3 cases, the free posterior interosseous artery flaps were used in 7 cases, and the free perforator flap based on the radiodorsal septocutaneous perforator of the posterior interosseous artery were used in 6 cases. Partial necrosis happened in one case at the distal portion of the flap. Muscular branch of the posterior interosseous nerve was injured in one case with conventional reverse posterior interosseous artery flaps. All the other flaps survived uneventually with no complication. All wounds were primarily healed. 32 cases were followed up for 1 to 48 months with satisfactory aesthetic and functional results both in the donor sites and in the recipient areas. The color,texture and thickness of the flaps were satisfied as well.

CONCLUSIONSThe posterior interosseous artery flap has a constant vascular anatomy and a great flexibility, which is practical and suitable for repair of Soft tissue defect in the upper extremities arising from burn and traumatic injury.

Adolescent ; Adult ; Burns ; surgery ; Female ; Forearm ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome ; Young Adult

OBJECTIVETo discuss the therapeutic effect and clinical experience of a new technique of digital reconstruction with the free mesio-forearm flap based on perforator of ulnar artery.

METHODSWe marked the line from the pisiformis to the condylus medialis humeri as the axis of the flap. We used Doppler to detect the site of the mesio-forearm ulnar perforator which is usually 9-10 cm proximal to the condylus medialis humeri as center of the flap. We designed the flap that contained perforator artery with its accompanying vein of the ulnar artery and a superficial vein around the center spot along the axis of ulnar artery. The wound at donor site was sutured directly. Neurorrhaphy was not conducted in any cases.

RESULTSFrom June 2005 to June 2009, all 12 flaps survived with good quality and aesthetic contour. And no necrosis occurred. We conducted 6-36 months follow-up, and the result was satisfactory. The function of the fingers was reserved. Two-point discrimination differed from 6 cm to 12 cm.

CONCLUSIONSThe free ulnar perforator flap on mesio-forearm can repair digital defect with good therapeutic effect, leaving less morbidity at donor site.

Adolescent ; Adult ; Female ; Forearm ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome ; Ulnar Artery ; surgery ; Young Adult

OBJECTIVETo introduce a new flap for the repair of soft tissue defects in the hand.

METHODSThe distally pedicled ulnar flap is based on the ascending branch of the upper-wrist cutaneous branch of the ulnar artery. The retrograde flow is ensured by the dorsal carpal arch via the descending branch.

RESULTSFrom 2000 to 2003, the flap was used to treat 8 cases of hand defects, including 3 dorsal defects, 2 palmar defects and 3 the first web defects. All flaps survived and the appearance was satisfactory.

CONCLUSIONSThe reverse forearm flap pedicled with the ulnar branch of the ulnar artery provides a long vascular pedicle. The donor site scar is aesthetically acceptable.

Adult ; Female ; Forearm ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Ulnar Artery ; surgery ; Wrist