Arteries to the great and second toes based on three-dimensional analysis of 100 cadaveric feet

Hamada, Norikazu; Ikuta, Yoshikazu; Ikeda, Akira

doi:10.1007/bf01627702

Cited by 27 publications

(12 citation statements)

References 13 publications

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“…A few studies have reported on the arterial anatomy of the second toe. Hameda reported that the first dorsal (in 78% of the feet studied) and plantar metatarsal arteries (22%) supplied blood from the medial side, and the second dorsal (78%) and plantar metatarsal arteries (22%) did so from the lateral side 4. Despite the importance of toenail transfer, the exact location of the branches of the digital artery has not been fully defined.…”

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confidence: 99%

Arterial anatomy of the second toe nail bed related to toenail transfer

Hwang

Choi

et al. 2010

Microsurgery

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The aim of this study was to elucidate the exact course of the terminal branches of the plantar digital artery (PDA) to the nail bed of the second toe. Thirteen second toes from seven fresh Korean cadavers were dissected (age range 74-92 years, four men and three women). The terminal segmental branches (TSB) branched off from the PDA at 7.6 ± 0.7 mm proximal to the nail fold. The fibro-osseous hiatus branch (FHB) branched off from the PDA at 3.3 ± 0.7 mm from the nail fold. They were 3.8 ± 1.0 mm lateral to the paronychium. Diameters of TSB and FHB were 0.8 ± 0.2 mm and 0.7 ± 0.1 mm, respectively. Diameter of PDA was 1.4 ± 0.2 mm. Surgeons should stay at least 4 mm proximal to the nail fold to avoid injury to the terminal branch. We believe that second toenail with minimum amount of soft tissue may be transferred using FHB-based vascularized toenail flap. Perfusion study and clinical application should be followed.

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confidence: 99%

Arterial anatomy of the second toe nail bed related to toenail transfer

Hwang

Choi

et al. 2010

Microsurgery

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“…The vascular anatomy of the second toe and MT2 has been reported previously. [14][15][16] The first dorsal metatarsal artery gives off several musculoperiosteal branches to the MT2 and, although not specifically studied in the present article, it is reasonable to assume that after careful limited periosteal stripping, the two segments of the osteotomized MT2 would retain adequate vascularity. Further research in this regard is warranted.…”

Section: Discussionmentioning

confidence: 79%

Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study

Cavadas¹,

Thioné

Martínez³

2016

Jnl Wrist Surg

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Background The ulnar head is a key stabilizer of the wrist and forearm. The authors investigated the possibility of using the second metatarsal bone to replace the distal ulna in an anatomical study. Methods The morphology of the distal ulna and the head of the second metatarsal (MT2) were studied using three-dimensional computerized tomographic (CT) scans of the wrist and foot in 52 patients without pathology related to these two areas, and 11 cadaveric specimens. The radius and height of the best-fit cylinder for both epiphyses were measured in the CT scans and compared. In the cadaveric specimens an osteotomy of the metatarsal neck was performed to rotate 90 degrees the head of the MT2 to match the shape of the distal ulna. Results The osseous morphology of the distal ulna and the head of the MT2 are roughly cylindrical, but differently oriented relative to the diaphyseal axes. In the osteotomized cadaveric MT2specimens, the overall morphology was relatively similar that of the distal ulna. The mean length of the MT2 after the osteotomy was 65 mm. Conclusion The head of the MT2 was found to have a similar cylindrical morphology to that of the ulnar head, with a different orientation. The radius of the cylinder was similar, although the height was bigger for the MT2. After a rotation osteotomy of the neck of the MT2 the overall shape and orientation of the epiphysis was more similar to the distal ulna. A vascularized transfer of an osteotomized MT2 would be an option for autologous reconstruction of the distal ulna in selected patients, but further study is needed in terms of the vascular supply, ligamentous reconstruction, and reconstruction of the sigmoid notch. Level of Evidence Therapeutic, level IV.

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“…19 Several other studies have reported dorsal-dominant blood supply to the second toe as high as 78%. 20,21 In our review, 7 of 11 patients (63%) were noted to have a plantar-dominant vascular system, one patient had a nondominant vascular system, and three patients had a dorsal-dominant system. The flap is typically disarticulated at the metatarsophalangeal joint, but it can also be taken distal or proximal to this level.…”

Section: Operative Techniquementioning

confidence: 83%

Simultaneous Double Second Toe Transplantation for Reconstruction of Multiple Digit Loss in Traumatic Hand Injuries

Herrera

Lee

Brooks

et al. 2009

J reconstr Microsurg

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The objective of this study is to review a single institution's 10-year experience of simultaneous double second toe transplantations for reconstruction of traumatic hand injuries. Eleven cases of traumatic hand injuries treated with simultaneous double second toe transplantation for digital reconstruction were retrospectively reviewed. All patients sustained traumatic injury resulting in multiple digit loss not amenable to replantation. A simultaneous three-team approach was performed in all cases. The average operating time was 9 hours (range 7 to 15 hours). The mean time to reconstruction was 5.7 months following injury (range 2 to 15 months). Mean hospital stay was 8 days (range 6 to 11 days). Complications included microvascular thrombosis in two toes, loss of one transplanted toe, hematoma, and wound infection. Twenty-one toes survived; secondary surgery was performed in ten patients. Average moving 2-point discrimination was 8 mm in each digit at 7-month follow-up. Mean grip and pinch strength approached 67% of the contralateral hand. Mean time to return to work after finger reconstruction was 10 months. Simultaneous double second toe transplantation is a useful and efficient option for multidigit reconstruction. A three-team approach allows for single-stage reconstruction resulting in decreased operative time, decreased hospital stay, and good functional outcomes when compared with alternative techniques.

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Arteries to the great and second toes based on three-dimensional analysis of 100 cadaveric feet

Cited by 27 publications

References 13 publications

Arterial anatomy of the second toe nail bed related to toenail transfer

Arterial anatomy of the second toe nail bed related to toenail transfer

Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study

Simultaneous Double Second Toe Transplantation for Reconstruction of Multiple Digit Loss in Traumatic Hand Injuries

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