摘要：
Objective: To investigate and evaluate the clinical application of the posterolateral aspect of the mid - forearm ( PLMF ). Methods:30 embalmed upper limbs of adult cadavers perfused with red latex were used for this study, the origin, branches, and distribution of the perforating arteries at posterolateral aspect of the mid - forearm were observed through meticulous dissection on one fresh cadaver, HAES - steril and ink compound was perfused through the brachial artery, after which the staining area of the skin isolated on the perforating arteries was measured. Based on the anatomical study, 11 cases of perforator flaps at the posterolateral aspect of the mid - forearm were harvested to repair soft tissue defects in the forearm and wrist. Results: Perforating branches of posterolateral midforearm originated from the radial musculoculancous branches of the posterior interosseous artery, the intermuscular branch and direct periosteal branch of the radial artery traveled through the space between extensor digitorum and extensor carpi radialis brevis supinator and abductor pollicis longus, supi-nator and abductor pollicis longus, emerging from the deep fascia subcutaneously at 12.5~15.8 cm below the lateral condyle of humerus. Several minute branches were emitted from these perforating branches to participate in the formation of the paraneural and intraneural vascular plexuses of the posterior antebrachial cutaneous nerve. The diameter of the perforating arteries after piercing the deep fascia was ( 1.0±0. 3 )cm,( 0. 9 ±0. 2 ) cm and ( 0. 6 ±0. 2 )cm, respectively. The ink staining area was 13 cm x7 cm. Clinically, all flaps in 13 cases survived uneventfully without cyanose, swelling or blister. After 3 ~ 15 months of following - up, the colors and appearances of these flaps were excellent. Conclusions: The anatomy of the perforating arteries at the posterolateral aspect of the mid - forearm are relatively constant; and the flap based on them are profuse in blood supply, simple in surgical technique, and suitable for repairing soft tissue defects in either forearm or wrist.%目的:探讨与评价前臂后外侧中段穿支血管皮瓣的临床应用效果.方法:取动脉灌注红色乳胶的成人上肢标本30侧,解剖观测前臂后外侧中段穿支的起源、分支与分布规律;取新鲜成人上肢标本1例,行肱动脉插管灌注贺斯墨汁混合液并测量皮肤染色面积.临床设计前臂后外侧中段穿支皮瓣,并转位修复前臂、腕部软组织缺损11例.结果:来源于骨间后动脉桡侧肌皮支、桡动脉肌间隙支和桡动脉直接骨膜支的前臂后外侧中段穿支的位置相对恒定,在指伸肌与桡侧腕短伸肌的肌间隙、旋后肌与拇长展肌之间(肱骨外上髁下12.5～15.8 cm范围内)穿过深筋膜至皮下,并分出众多的细小血管与前臂后皮神经的神经旁和神经干血管链的分支吻合.其穿支穿出深筋膜后外径分别为(1.0±0.3)cm、(0.9±0.2)cm和(0.6±0.2)cm.墨染面积达13 cm×7 cm.临床11例术后皮瓣完全成活,皮瓣无青紫、明显肿胀、水泡等,创面I期愈合,经3～15个月随访,皮瓣色泽接近正常,质地和外形优良.结论:前臂后外侧中段穿支解剖位置恒定、血液供应良好,手术方法简单,适用于修复手部、前臂软组织的缺损.
