Abstract
OBJETIVO: Realizar estudo anatômico da artéria colateral média, analisando sua frequência, origem e possibilidade do emprego do retalho lateral do braço estendido com pedículo alongado em "Y-V" de fluxo retrógrado. MATERIAIS E MÉTODOS: Foram dissecados treze braços de treze cadáveres do sexo masculino, extraindo-se o comprimento do úmero, origem da artéria colateral média, comprimento da artéria colateral média, da sua origem até a penetração no ventre lateral do tríceps, e o diâmetro da artéria. RESULTADOS: Observaram-se a presença da artéria colateral média em todos os membros, o comprimento médio do úmero foi de 31,89 cm. Em 61,5% dos casos, a artéria colateral média originou-se da artéria colateral radial posterior, enquanto que em 38,5% a origem foi da artéria braquial profunda. O comprimento da artéria colateral média variou de 3,2 a 6,8 cm (média de 4,97cm). O diâmetro médio foi de 1,27 mm. CONCLUSÃO: A artéria colateral média é constante, origina-se na maioria dos casos da artéria colateral radial posterior, tornando viável a aplicação clínica do retalho lateral do braço estendido com fluxo sanguíneo retrógrado com pedículo alongado em "Y-V".
Highlights
The cutaneous coverage of extensive lesions of the forearm, from its middle third to the wrist, is still a challenge in reconstructive surgery.[1,2,3,4] The flexor and extensor tendons of the fingers and of the wrist, the median, ulnar and radial nerves, the radius and the ulna are vulnerable to lesions of greater energy, such as exposed fractures and extensive wounds
Two pedicle patterns were observed, classified according to the point of origin of the middle collateral artery: a distal group, at a distance of less than 15 cm from the lateral epicondyle, in 8 arms (61.5%) and another proximal, at a distance of more than 17 cm from the lateral epicondyle, in 5 arms (38.5%)
The middle collateral arteries originated from the posterior radial collateral artery, while in the proximal group they originated from the deep brachial artery
Summary
The cutaneous coverage of extensive lesions of the forearm, from its middle third to the wrist, is still a challenge in reconstructive surgery.[1,2,3,4] The flexor and extensor tendons of the fingers and of the wrist, the median, ulnar and radial nerves, the radius and the ulna are vulnerable to lesions of greater energy, such as exposed fractures and extensive wounds. Coverage procedures through rotation of local flaps represent a solution that is often impracticable due to the lesions of the vessels that supply them. The microsurgical free flaps of the arm, the contralateral forearm, the back or the abdomen were described in an attempt to resolve this problem. These procedures require ample dissections in two different surgical fields and the sacrifice of important vessels. There is a need for vascular microanastomoses, with their technical difficulties and vulnerability.[1]
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