Angiosome territories of the nerves of the upper limbs.
BACKGROUND
The use of free vascularized nerve grafts requires intimate knowledge of the blood supply of peripheral nerves. The authors aimed to demonstrate radiographically the topography of the upper limb nerves with their blood supply, and to examine them as an application of the angiosome concept. An angiosome is a three-dimensional block of composite tissue supplied by a single source artery.


METHODS
This anatomical study involved the meticulous dissection of four fresh upper limb specimens injected intraarterially with a gelatin-lead oxide mixture. The nerves were tagged circumferentially with copper wire and radiographs were taken of the nerves with their arterial blood supply. The median, ulnar, radial, musculocutaneous, and axillary nerves were examined.


RESULTS
The authors showed that the nerves of the upper limb were supplied segmentally by source vessels, which reinforced the angiosome concept. The suitability of each nerve for harvest in free vascularized nerve transfer was assessed according to its pattern of blood supply.


CONCLUSIONS
The authors' work has a wide range of clinical applications and provides an anatomical basis for neurovascular and neurocutaneous flaps and free vascularized nerve grafting.
Hong
Matthew K-H
MK
Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, University of Melbourne, Parkville, Victoria 3010, Australia.
Hong
Michael K-Y
MK
Taylor
G Ian
GI
D001132:Arm / Q000294:innervation; D001158:Arteries / Q000033:anatomy & histology; D001365:Axilla / Q000294:innervation; D004210:Dissection; D005542:Forearm / Q000294:innervation; D006801:Humans; D007269:Injections, Intra-Arterial; D008475:Median Nerve / Q000098:blood supply; D009138:Musculocutaneous Nerve / Q000098:blood supply; D010525:Peripheral Nerves / Q000098:blood supply* / Q000000981:diagnostic imaging; D011826:Radial Nerve / Q000098:blood supply; D011859:Radiography; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation*; D014459:Ulnar Nerve / Q000098:blood supply; D034941:Upper Extremity / Q000294:innervation*