Abstract
Introduction There is an increase in the use of the pronator quadratus (PQ) as a functional flap for facial and upper limb reconstructions, predominantly based on the pedicle of the anterior interosseous artery and nerve. However, growing literature about the dimensions of the components of the flap, is scarce, especially in the Latin-American population. Therefore, the morphological description of the dimensions of the muscle, artery, nerve, and concomitant veins was carried out.
Materials and Methods Dissections were performed on 10 fresh cadaver upper extremities at CLEMI. Measurements and photographic material were taken of the dimensions of the muscle and neurovascular pedicle, for subsequent statistical analysis.
Results After statistical analysis, an average of 4.3 cm wide, 4.8 cm long, and 0.9 cm thick was established for the muscle. Regarding the anterior interosseous artery (AIA), an average length of 12.5 cm with proximal and distal diameters of 1.6 mm and 2.2 mm respectively, and anastomosis with the posterior interosseous artery (PIA) in 80% of cases. In relation to the anterior interosseous nerve (AIN), it had an average length and diameter of 12.2 cm and 0.9 mm, respectively, with 9.8 cm from the branch of the flexor pollicis longus (FPL) to the pronator quadratus and 13.7 cm from the wrist crease. A single vein was evident in 60% of cases with a diameter of 0.9 mm.
Conclusion A constant anatomy was observed in the pronator quadratus flap, with an artery, vein, and nerve of adequate length and diameter for easy anastomosis and neurorrhaphy. This was associated with low morbidity of the donor area, configuring it as a useful tool in the reconstructive process.
Keywords
pronator quadratus - anterior interosseous nerve - neurovascular pedicle - flap
