Rib anastomosis

The ribs also have an independent blood supply system, namely intercostal arteries and veins. The intercostal artery starts from the dorsal side of the autonomic artery and is divided into anterior and posterior branches beside the spine. The posterior branch supplies the paravertebral muscles, meninges, and spinal cord, and the anterior branch is the intercostal artery [Figure 1 图]. The intercostal artery passes through the pleura and the lower edge of the ribs, enters the intercostal inner muscle and the innermost muscle, and is divided into upper and lower branches. The upper branch is inclined diagonally to the rib angle and enters the rib groove of the previous rib; the lower limbs run forward along the upper edge of the next rib. Both the upper and lower branches of the anastomosis coincide with the intercostal branches of the internal thoracic artery [Figure 1⑵]. In addition, the intercostal arteries also have many musculocutaneous arteries that supply the periosteum, intercostal muscles, and the skin above them. Therefore, according to clinical needs, anastomotic rib transplantation or rib skin flap transplantation is feasible.