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 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 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 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 evaluate the curative effects of manipulative reduction for children's type III humeral supracondylar fracture and the preventions of ischemic contracture of forearm in the early period.

METHODSFrom September 2008 to September 2011, 38 patients with humeral supracondylar fractures were treated with manipulative reduction and plaster stabilization, including 20 males and 18 females with an average age of 7.5 years (ranged, 2 to 13 years); the average time from injury to visit was 1.8 days(ranged,0.5 h to 6 d). There were 21 cases in straighten-ulnar deviation type and 17 cases in straighten-radial deviation type, 1 case in flexion type,all of them without vascular nerve injury. It was important to process swelling correctly in early stage of fracture. To decide fixed position according to the original displacement, and make a regular X-ray review, if found another displacement to correct it in 1-2 weeks after injury in time. Dismantle the plaster on the basis of bone healing and guide the functional exercise of elbow joint. According to Dodgt standard to evaluate clinical effects.

RESULTSAll patients were followed up from 3 months to 1 year with an average of 7 months. All fractures healed. According to Dodgt standard, 14 patients got an excellent results, 19 good, 4 fair and 1 poor. The excellent and good rate was 86.84%.

CONCLUSIONIt can obtain satisfactory clinical effects to treat humeral supracondylar fracture in children with closed manipulative reduction and plaster stabilization, while without vascular nerve injury. Early correct processing swelling and paying attention to gypsous angle can effectively prevent the ischemic contracture of forearm.

Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Forearm ; blood supply ; Humans ; Humeral Fractures ; therapy ; Ischemic Contracture ; prevention & control ; Male ; Manipulation, Orthopedic

OBJECTIVETo investigate the feasibility and safety of right heart catheterization through the antebrachium veins.

METHODSA total of 68 consecutive patients suspected with pulmonary vascular diseases underwent standard right heart catheterization and pulmonary angiography through the antebrachium veins were enrolled in this multicenter, cross-sectional study.

RESULTSThe rate of successfully inserting the sheath into antebrachium veins was as high as 97.1% (66/68) and the rate of successfully performing right heart catheterization or pulmonary angiography through vascular access of antebrachium veins was 91.2% (62/68). The reasons of unsuccessful inserting the catheter to the right heart were due to the abnormality of antebrachium veins (2 cases) or stenosis of subclavian vein (3 cases) or unsatisfactory engorging of antebrachium veins since the history of drug injection (1 case). Haemorrhage of branch of axillary vein was the only adverse event occurred in one patient.

CONCLUSIONIt is a safe, convenient and well-tolerant option to perform right heart catheterization and pulmonary angiography through the vascular access of antebrachium veins.

Adult ; Angiography ; methods ; Cardiac Catheterization ; methods ; Cross-Sectional Studies ; Feasibility Studies ; Female ; Forearm ; blood supply ; Humans ; Male ; Middle Aged ; Pulmonary Artery ; diagnostic imaging ; Veins ; Young Adult

BACKGROUNDSural neurofasciocutaneous flap has been popularly used as an excellent option for the coverage of soft tissue defects in the lower third of leg, ankle and foot, but its free transplantation has been rarely reported. The objective of our work was to investigate the operative technique and clinical results of repairing the soft tissue defects of hand and forearm with free peroneal perforator-based sural neurofasciocutaneous flap.

METHODSBetween May 2006 and March 2007, 10 patients including 7 men and 3 women were treated. Their ages ranged from 22 to 51 years. They presented to emergency with large soft tissue defects of 16 cm x 7 cm to 24 cm x 10 cm in size in hand and forearm after injured by motor vehicle accidents (2 cases) or crushed by machine (8 cases). Thorough debridements and primary treatments to associated tendon ruptures or bone fractures were performed on emergency. And free peroneal perforator-based sural neurofasciocutaneous flaps were transplanted when the wound areas were stable at 5 to 7 days after emergency treatment. The flaps were designed along the axis of the sural nerve according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascular anastomosis. Then the flaps were harvested to repair the recipient sites with the peroneal artery anastomosed to the radial (or ulnar) artery and the peroneal veins to one of the radial (or ulnar) veins and the cephalic vein respectively. The flap sizes ranged from 18 cm x 8 cm to 25 cm x 12 cm. The donor areas were closed by skin grafts.

RESULTSAll of the 10 flaps survived after surgeries. Marginal necrosis occurred in only 2 cases. The skin grafts survived entirely in the donor sites, and no obvious influence on the donor legs was observed. All of the transplanted flaps presented favourable contours and good functions at 9 to 12 months' follow-up.

CONCLUSIONSPeroneal perforator-based sural neurofasciocutaneous flap has favourable appearance, constant vascular pedicle, reliable blood supply, large size of elevation, and minimal influence on the donor site. The free transplantation of this flap offers a satisfactory alternative for repairing the large soft tissue defects of forearm and hand.

Adult ; Female ; Forearm Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; innervation ; Treatment Outcome ; Young Adult