Anatomical Study of the Fingertip Artery in Tamai Zone I: Clinical Significance in Fingertip Replantation

Nam, Yong Seok; Jun, Young Joon; Kim, In‐Beom; Cho, Sunghun

doi:10.1055/s-0036-1588005

Cited by 16 publications

(13 citation statements)

References 19 publications

(31 reference statements)

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“…Because fingers have very little muscles, the stretching of muscles during straightening of fingers may have no effect. Instead, there is a web of veins and capillaries in the fingertip, and this web is likely to be more dense in digit 2 than in digit 4 (41, 42). Therefore, with deliberate straightening of fingers, more blood may flow into the fingertips and, in particular, more so into the tip of digit 2 than into the tip of digit 4.…”

Section: Discussionmentioning

confidence: 99%

Differential Placing of Flexion Creases Contributes to Sex Differences in the Second-to-Fourth Digit Ratio (2D:4D)

2019

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The present research examined whether differential placing of the basal flexion creases contributes to the occurrence of sex differences in digit ratio (2D:4D) derived from palmar digit lengths. The ratio of palmar-to-dorsal digit length, a measure of the placing of the basal flexion crease in the finger, was derived for the digits 2 and 4 of the right hand in two independent samples (Study I: N = 100; Study II: N = 200), in accordance with discovery-replication sample approach. The results show that men have lower palmar-to-dorsal digit ratios than women, and this effect is significantly stronger for digit 2 than for digit 4. Thus, the present study supports the likelihood that differential placing of flexion creases in the digits contributes to the occurrence of sex differences in palmar 2D:4D. In addition (Study II), the measurement procedure assessing the placing of flexion creases was validated. In conclusion, this evidence highlights potential conceptual shortcomings and technical limitations in the measurement conventions and methods currently employed in the field of 2D:4D research.

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Section: Discussionmentioning

confidence: 99%

Differential Placing of Flexion Creases Contributes to Sex Differences in the Second-to-Fourth Digit Ratio (2D:4D)

2019

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“…However, when replantation is performed, the result is much better than other options in terms of achieving good function and aesthetic appearance. However, although the anatomy of the region is well defined, fingertip replantation has several difficulties (Nam et al, 2017). Identification and repair of small‐diameter vessels and nerves poses these challenges.…”

Section: Discussionmentioning

confidence: 99%

“…Neurovascular anatomy differs at different finger levels. At the level of distal to the nail fold, the digital arteries join with each other and form the distal transverse palmar arch and one or more dominant arteries branch from this arch, the digital nerves are also branched at this level (Nam et al, 2017). Therefore, nerve coaptation at this level can be a challenge due to difficulty in coaptation and increased operative time.…”

Section: Introductionmentioning

confidence: 99%

Assessment of sensory outcomes after successful fingertip replantation with or without nerve repair according to amputation level

et al. 2021

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Background Good sensory outcome in fingertip replantation is a major part of the success of reconstruction and using the finger. Although some sensorial outcomes have been reported in various series in the literature, there is no controlled study, which demonstrates the anatomical levels where nerve repair should or should not be performed. We aimed to assess sensorial outcomes of fingertip amputations with or without nerve coaptation according to amputation level. Methods Between January 2013 and July 2018, patients with Tamai Zone 1 and Zone 2 amputations underwent replantation. The patients were divided two main groups. Patients underwent nerve coaptation were grouped as Group 1, and those coaptation not performed as Group 2. In addition, subgroups were designed according to level of the amputation. Tamai zone 1 amputations were grouped as groups 1a and 2a. Tamai zone 2 amputations were grouped as groups 1b and 2b. The mean age was 30.8 ± 30.8 years in Group 1a, 33.2 ± 12.6 years in Group 1b, 34.1 ± 13.6 years in Group 2a, 34.3 ± 11.1 years in Group 2b. Type of injury were evaluated as clean cut (with knife, saw etc.), moderately crushed, and severely crushed and/or avulsion. In Group 1a, one prominent branch of the nerve was repaired, and in Group 1b, the nerve in both side was repaired. The mean duration of replantation in Group 1a was 1 h and 40 min (1 h and 15 min–2 h), whereas this time was 1 h and 15 min (1 h ‐ 1 h and 35 min) in Group 2a. Then, 2 h 15 min (1 h and 55 min–2 h and 50 min) in Group 1b, and 2 h (1 h and 45–2 h 25 min) in Group 2b. Mean age, type of injury and length of follow‐up were statistically compared. Sensorial outcome was evaluated by 2‐point discrimination test and the Semmes–Weinstein test. Results According to the Semmes–Weinstein test, 33% of the fingers tested were normal, 58% had diminished light touch, 8% had diminished protective sensation, and 0% had loss of protective sensation in Group 1a; In Group 1b, these values were 35% (7/20), 55% (11/20), 10% (2/20), 0%; in Group 2a, 38% (6/16), 56% (9/16), 6% (1/16), 0%; in Group 2b, 25% (4/16), 44% (7/16), %25 (4/16), 6% (1/16), respectively Mean static two‐point discriminations in Groups 1a, 1b, 2a, and 2b were 4.17 ± 0.58, 4.55 ± 0.69, 4.25 ± 0.68, and 5.9 ± 1.26 mm, respectively. The mean follow‐up duration was 24 months in Group 1a, 24 months in Group 1b, 26 months in Group 2a, 21 months in Group 2b. Then, 17 (3 in Group 1a, 6 in Group 1b, 4 in Group 2a, 4 in Group 2b) of the 64 fingers were clean cut amputation, 45 (9 in Group 1a, 14 in Group 1b, 11 in Group 2a, 11 in Group 2b) were moderately crushed amputation, and 2 (1 in Group 2a, 1 in Group 2b) were severely crushed and/or avulsion injury. There was no statistically significant difference between groups 1a and 2a (p = .71). On the other hand, there was a statistically significant increase in sensory outcomes of patients in Group 1b compared to Group 2b (p = .009). There was no statistically significant between the groups in terms of mean age, type of injury and l...

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“…Previous studies revealed that the two palmar digital arteries join at the lunula level and form the DTPA [9]. From the DTPA, central arteries are branched [10].…”

Section: Discussionmentioning

confidence: 99%

Fingertip Reconstruction with Subcutaneous Island Flap and Composite Graft: A Case Report

Park¹,

Koh²,

Lee³

et al. 2020

Arch Hand Microsurg

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Reconstruction of amputated fingertips is extremely challenging when the amputee is very small and severely crushed. Moreover, there are not many options if distal phalanx is exposed due to defects of soft tissue. We report a case of successful fingertip reconstruction in a 10-month-old girl using a subcutaneous island flap with a composite graft. Her fingertip of the right little finger was amputated stuck by the air purifier. Some soft tissue was lost from the stump and the bone was exposed. There was a very small amputee, and soft tissue was extremely little inside. Replantation was not possible because of the soft tissue defect. The composite graft was inadequate due to the exposure of distal phalanx and defect of soft tissue. Soft tissue island ﬂap based terminal branch of the digital artery was transposed to cover the distal phalanx. After then, the amputee was grafted over the flap. After debridement, most of the soft tissue survived and 0.2×0.2 cm of skin defect was found, which was healed through secondary intention.

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Anatomical Study of the Fingertip Artery in Tamai Zone I: Clinical Significance in Fingertip Replantation

Cited by 16 publications

References 19 publications

Differential Placing of Flexion Creases Contributes to Sex Differences in the Second-to-Fourth Digit Ratio (2D:4D)

Differential Placing of Flexion Creases Contributes to Sex Differences in the Second-to-Fourth Digit Ratio (2D:4D)

Assessment of sensory outcomes after successful fingertip replantation with or without nerve repair according to amputation level

Fingertip Reconstruction with Subcutaneous Island Flap and Composite Graft: A Case Report

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