Abstract

RODRIGUEZ LORENZO, A.; MORRIS, S.F.; CARRERA BURGAYA, A.  and  MARTELO VILLAR, F.. Arterial anatomy of the extensor carpi radialis longus and extensor carpi radialis brevis muscle flaps related to its use in free functioning muscle transfer. Cir. plást. iberolatinoam. [online]. 2008, vol.34, n.3, pp.167-173. ISSN 1989-2055.

The arterial anatomy of the Extensor Carpi Radialis Longus and Brevis (ECRL, ECRB) flaps is herein described in order to provide the vascular basis to be used as free muscle transfer for facial reanimation. We used 29 fresh above-elbow human arms injected by means of two diferent techniques.Latex-injection was performed in 18 arms and the modified lead oxide-gelatine injection technique was performed in 11 arms. The ECRL and ECRB with their pedicles were dissected, photodocumented and radiographied.The number, length and calibers of the muscle pedicles were recorded. The intramuscular vascular pattern and the relations of the main pedicles of the muscles with the radial nerve were also noted. Two vascular patterns were found following the Mathes and Nahai Classification of the Vascular Anatomy of the Muscles (number of pedicles and its dominance): Type I (37,9% of ECRL and 20,7% of ECRB dissections) and Type II (62,1% of ECRL and 79,3% of ECRB dissections). The dominant pedicle for the ECRL (with an average caliber of 1,73 mm and an average length of pedicle of 32,32 mm) is a branch of the radial recurrent artery in 100% of the dissections and the dominant pedicle for the ECRB (with an average caliber of 1,11 mm and an average length of pedicle of 27,77 mm) a branch of the radial artery in 68,9% of the dissections and a branch of radial recurrent artery in 31,1% of the cases. As a conclusion, ECRL and ECRB muscle flaps present two types of vascular patterns: type I and type II.Type II pattern is the most common in our study. The anatomical features of both muscles (vascular basis,presence of an important fascial layer, contour and length of the muscle,) make them reliable as free muscles flaps for facial reanimation, however, the relation between the dominant pedicle for the ECRL muscle flap with the posterior interosseous branch of the radial nerve make not possible to free the flap without sacrificing the nerve in most of the cases.

Keywords : Facial reanimation; Free functioning muscle transfer; Extensor Carpi Radialis Longus; Extensor Carpi Radialis Brevis.

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