A study of the fasciocutaneous vascularisation of the arm. Surgical applications.

The data on the fasciocutaneous vascularisation of the medial aspect of the arm are incomplete in the literature. This study presents the methodology and results of an anatomic study on 19 upper limbs with arterial injection. The vascularisation of the upper part of this region is provided in 68% of cases by the superficial fasciocutaneous branch (SFCB) of the superior ulnar collateral artery (SUC), that of the middle and lower part by 3-4 fasciocutaneous pedicles originating from the SUC which are prolonged distally by the recurrent posterior ulnar artery. The SFCB has important relations with the ulnar nerve; it travels dorsal to the nerve in 64% of cases and then allows the raising of a distally-pedicled ulnar flap with a 3:1 ratio. In other anatomic configurations, a flap with retrograde flow supplied by the inferior pedicles of the SUC can always be raised. Its ratio is then 2:1. this flap allows coverage of all cases of posterior or anterior losses of substance at the elbow. These results supplement the data required for the raising of a distally-pedicled medial brachial flap, but also of a proximally-pedicled superior medial brachial flap and of a free superior medial brachial flap transposed by microsurgical means.