並列タイトル等尺骨偽関節に対する前骨間動脈を血管茎とした橈骨遠位からの有茎血管柄付き骨移植：解剖学的研究と症例報告
一般注記type:Thesis
Background: A vascularized distal radius graft can be a reliable solution for the treatment of refractory ulnar nonunion. The aim of this study is to establish the anatomical basis of a vascularized bone graft pedicled by the anterior interosseous artery and report its clinical application, using cadaveric studies and a case report. Methods: Fourteen fresh frozen cadaveric upper limbs were used. The branches of the anterior interosseous artery (the 2, 3 intercompartmental supraretinacular artery and the fourth extensor compartment artery) were measured at the bifurcation site. The anatomical relationship between the anterior interosseous artery and motor branches of the posterior interosseous nerve was investigated. An anterior interosseous artery pedicled bone flap was used in a 48-year-old woman with refractory ulnar nonunion. Results: There were two variations depending on whether the 2,3 intercompartmental supraretinacular artery branched off distally or proximally from the terminal motor branch of the posterior interosseous nerve. The proximal border of the graft was located at an average of 10.5 cm (range, 6.5-12.5 cm) from the distal end of the ulnar head in the distal type (57%) and 17.5 cm (range, 9.5-21.5 cm) in the proximal type (43%). In the clinical application, successfully consolidation was achieved 4 months post-surgery. The patient had not developed any postoperative complications until the 2-year postoperative follow-up. Conclusions: The anterior interosseous artery-pedicled, vascularized distal radius bone graft would be a reliable alternative solution for the treatment of an ulnar nonunion located within the distal one-third of the ulna.
博士（医学）・甲第767号・令和3年3月15日
© 2020 Wiley Periodicals, Inc.
This is the peer reviewed version of the following article: https://onlinelibrary.wiley.com/doi/full/10.1002/micr.30566, which has been published in final form at https://doi.org/10.1002/micr.30566. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
identifier:Microsurgery Vol.40 No.4 p.479-485 (2020 May)
identifier:07381085
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3891
identifier:Microsurgery, 40(4): 479-485
DOIinfo:doi/10.1002/micr.30566
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