{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T14:13:31Z","timestamp":1719670411660},"reference-count":54,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund\u2002Anomalien des Gef\u00e4\u00dfsystems des Unterarmes k\u00f6nnen bei der mikrochirurgischen Hebung einer A.\u2009radialis-Lappenplastik von gro\u00dfer Bedeutung sein. Insbesondere bei der Verwendung der fasziokutanen Radialislappenplastik zur Bildung eines Penoids ist auf Grund der erforderlichen Gr\u00f6\u00dfenausma\u00dfe der Lappenplastik eine suffiziente arterielle Versorgung von grundlegender Bedeutung. Beim Auftreten einer persistierenden A.\u2009mediana k\u00f6nnen dabei die Perfusionsverh\u00e4ltnisse im Versorgungsgebiet der A.\u2009radialis und der A.\u2009ulnaris ver\u00e4ndert oder diese sogar vollst\u00e4ndig r\u00fcckgebildet worden sein.<\/jats:p><jats:p>\n          Patienten und Methoden\u2002Es erfolgte eine retrospektive Auswertung aller in unserer Klinik durchgef\u00fchrten Phalloplastiken mit Radialispenoid von Januar 2016 bis Dezember 2018. Bei allen Patienten wurde die Technik nach Gottlieb und Levine oder nach Chang angewandt.<\/jats:p><jats:p>\n          Ergebnisse\u2002In der retrospektiv untersuchten Kohorte von 48\u2009Patienten wurde bei zwei Patienten intraoperativ eine persistierende A.\u2009mediana gefunden, was einer Inzidenz von 4,2\u2009% entspricht. Bei beiden Patienten gelang die hinsichtlich der Perfusion komplikationslose Bildung eines Radialispenoids ohne Einschr\u00e4nkungen der Lappenperfusion oder der Perfusion der Hand. Eine Literatur\u00fcbersicht liefert einen \u00dcberblick \u00fcber die Inzidenz auftretender Aberrationen der Vaskularisierung des Unterarmes und die daraus ableitbaren Konsequenzen f\u00fcr die Planung einer A.\u2009radialis-Lappenplastik.<\/jats:p><jats:p>\n          Schlussfolgerung\u2002Auch im Falle einer verl\u00e4sslichen mikrochirurgischen Lappenplastik wie der A.\u2009radialis-Lappenplastik sollten dem mikrochirurgisch t\u00e4tigen Chirurgen die M\u00f6glichkeiten der anatomischen Varianten der arteriellen Versorgung des Unterarmes, wie das Vorhandensein einer persistierenden A.\u2009mediana, bekannt sein. Der standardm\u00e4\u00dfig durchzuf\u00fchrende Allen-Test liefert in vielen F\u00e4llen keine eindeutige R\u00fcckschlussm\u00f6glichkeit und bedingt somit h\u00e4ufig erst intraoperative Zufallsbefunde. Eine sorgf\u00e4ltige pr\u00e4operative Planung und Evaluation der Perfusion sowie die Er\u00f6rterung von Alternativtechniken sind hierbei notwendig.<\/jats:p>","DOI":"10.1055\/a-1150-7517","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T22:59:06Z","timestamp":1590706746000},"page":"280-288","source":"Crossref","is-referenced-by-count":2,"title":["Erfolgreiche freie mikrovaskul\u00e4re A. radialis-Lappenplastik zur Phalluskonstruktion bei persistierender A. mediana (PMA)"],"prefix":"10.1055","volume":"52","author":[{"given":"Torsten","family":"Schlo\u00dfhauer","sequence":"additional","affiliation":[{"name":"AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universit\u00e4t Frankfurt am Main, Klinik f\u00fcr Plastische, \u00c4sthetische, Wiederherstellungs- und Handchirurgie"},{"name":"AGAPLESION EV Krankenhaus Mittelhessen, Akademisches Lehrkrankenhaus der Justus-Liebig-Universit\u00e4t Gie\u00dfen, Klinik f\u00fcr Plastische, \u00c4sthetische, Rekonstruktive und Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Kueenzlen","sequence":"additional","affiliation":[{"name":"AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universit\u00e4t Frankfurt am Main, Klinik f\u00fcr Plastische, \u00c4sthetische, Wiederherstellungs- und Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens Martin","family":"Rothenberger","sequence":"additional","affiliation":[{"name":"AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universit\u00e4t Frankfurt am Main, Klinik f\u00fcr Plastische, \u00c4sthetische, Wiederherstellungs- und Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Sader","sequence":"additional","affiliation":[{"name":"Goethe-Universitat Frankfurt am Main, Klinik f\u00fcr Mund-, Kiefer-, Plastische Gesichtschirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich Michael","family":"Rieger","sequence":"additional","affiliation":[{"name":"AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universit\u00e4t Frankfurt am Main, Klinik f\u00fcr Plastische, \u00c4sthetische, Wiederherstellungs- und Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,5,28]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-80508-0_35","volume-title":"Arteries of the forearm","author":"H Lippert","year":"1985"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.bjps.2007.10.026","article-title":"Median artery arising from the radial artery: its significance during harvest of a radial forearm free flap","volume":"61","author":"TO Acarturk","year":"2008","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s12565-015-0322-x","article-title":"Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature","volume":"92","author":"JA Arag\u00e3o","year":"2017","journal-title":"Anat Sci Int"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1002\/ca.21127","article-title":"Persistent median artery: Cadaveric study and review of the literature","volume":"24","author":"N Eid","year":"2011","journal-title":"Clinical Anatomy"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1097\/AAP.0b013e318260e458","article-title":"Persistent median artery (palmar type) and median nerve block in the forearm: observational study of prevalence","volume":"37","author":"JA Stimpson","year":"2012","journal-title":"Reg Anesth Pain Med"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/ajpa.1330960402","article-title":"Possible secular trend in the incidence of an anatomical variant: median artery of the forearm","volume":"96","author":"M Henneberg","year":"1995","journal-title":"Am J Phys Anthropol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1054\/jcms.2002.0300","article-title":"An unusual anomaly of the radial artery with potential significance to the forearm free flap. 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Literatur\u00fcbersicht"],"short-title":[],"issued":{"date-parts":[[2020,5,28]]},"references-count":54,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2020,8,21]]},"published-print":{"date-parts":[[2020,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1150-7517","relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,28]]}}}