Dorsal vascular network of the first web space

Dautel, G.; Borrelly, J; Merle, M.; Michon, Jacques

doi:10.1007/bf02096465

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…However, a Quaba pattern fourth dorsal metacarpal flap is always possible, although 35% of the flaps are actually based on perforators arising from the palmar metacarpal artery. Although there are detailed anatomical studies of the first and second dorsal metacarpal artery flaps (Dautel et al, 1989;Dautel and Merle, 1991;Earley, 1986;Earley and Milner, 1987;Sherif, 1994), there is a paucity of literature regarding the anatomy of the third to fifth dorsal metacarpal arterial flaps. Arria and Gilbert (1992) examined the first to fourth dorsal metacarpal arteries in 30 cadaveric hands and observed that the fourth dorsal metacarpal artery had a connection to the palmar system in 67% of the hands dissected.…”

Section: Discussionmentioning

confidence: 99%

The Anatomical Basis for Reverse First to Fifth Dorsal Metacarpal Arterial Flaps

Omokawa

Tanaka

Ryu

et al. 2005

Journal of Hand Surgery

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This study discusses the anatomical basis for reverse first to fifth dorsal metacarpal arterial flaps. The arterial pattern and size of the first to fifth dorsal metacarpal arteries were examined in 20 fresh cadaver hands. Their connections to the palmar arterial system at the metacarpal head were observed, and the location, number and diameter of skin perforators from each dorsal metacarpal artery were measured. The first to fourth dorsal metacarpal arteries were found in all specimens; the fifth dorsal metacarpal artery was found in 19 of our 20 specimens. The mean diameters of the first to fifth arteries at their bifurcation site were 0.6, 0.8, 0.5, 0.4 and 0.2 mm, respectively. Each artery gave off four to eight skin perforators (diameter: 0.1-0.3 mm) between the metacarpal head and base. The first to third dorsal metacarpal arteries consistently connected to the palmar arterial system, and connections between the fourth and fifth dorsal metacarpal arteries and the palmar system were found in 65% and 40% of specimens.

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Section: Discussionmentioning

confidence: 99%

The Anatomical Basis for Reverse First to Fifth Dorsal Metacarpal Arterial Flaps

Omokawa

Tanaka

Ryu

et al. 2005

Journal of Hand Surgery

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“…Dautel and colleagues [2] described a more detailed anatomical study and mentioned a superficial cutaneous artery directly arising from the radial artery. This vessel was distinguished from the FDMA because it had a very small diameter and ran in a very superficial plane compared to the FDMA network.…”

Section: Discussionmentioning

confidence: 99%

First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

et al. 2021

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Background Many approaches have been reported to repair soft-tissue defects of the hand using dorsal metacarpal artery flaps. Use of a perforator-based propeller flap from the first intermetacarpal space to the dorsum of the hand has been described. The aim of this study was to confirm the functional anatomy of a first dorsal metacarpal artery (FDMA) perforator flap. Methods Twenty-nine fixed cadaveric hands were dissected to determine the origin, course, and branches of the FDMA. Clinically, five cases of soft tissue defects of the hand underwent reconstructive surgery using an FDMA perforator-based propeller flap. ResultsThe FDMA was found in 27 specimens (93%). The ulnar branch of the FDMA always supplied the cutaneous perforator (mean ± SD, 4.3 ± 1.6), and the most distal cutaneous perforating branch was found along the metacarpal long axis within 25 mm of the tip of the metacarpal head with high frequency (28/29, 97%). In the two hands that had aplasia of the FDMA, well-developed perforators arose directly from the radial artery and advanced to the metacarpal head. Seven hands (24%) had perforators arising from the palmar arterial system, penetrating through or passing close by the second metacarpal bone. In clinical application, all the flaps survived completely without major complications. Conclusions The FDMA perforator-based propeller flap is minimally invasive and technically simple. It is expected to be a new option for hand reconstruction.

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“…One or two branches of the radial sensory nerve were also dissected with the flap (Figure 1(b)). One has to be extremely careful not to injure any large direct cutaneous artery (Dautel et al, 1989; Sherif, 1994), which may run with the cutaneous nerve, as it may be the dominant supply to the flap instead of the FDMCA. The fascia of the interosseous muscle was then incised at the radial border of the flap and dissection was continued deep to this layer protecting the pedicle.…”

Section: Methodsmentioning

confidence: 99%

The proximal first dorsal metacarpal artery free flap for reconstruction of complex digital defects

Hýža¹,

Kubek²,

Veselý³

et al. 2012

J Hand Surg Eur Vol

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We describe our experience and outcome with the 'Proximal first dorsal metacarpal artery free flap'. Ten consecutive cases utilizing the proximal first dorsal metacarpal artery free flap for complex digital defects were studied. Surgical technique, patient demographics, and flap outcome data were collected. Patient satisfaction was analysed using a questionnaire. All defects healed successfully with no loss of free flaps. The short-pedicle proximal first dorsal metacarpal artery free flap enables primary closure of the donor site up to 2 cm of width (in nine of the ten donor sites). The flap is a reliable and versatile alternative in selected cases of complex digital injuries.

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Dorsal vascular network of the first web space

Cited by 9 publications

References 6 publications

The Anatomical Basis for Reverse First to Fifth Dorsal Metacarpal Arterial Flaps

The Anatomical Basis for Reverse First to Fifth Dorsal Metacarpal Arterial Flaps

First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

The proximal first dorsal metacarpal artery free flap for reconstruction of complex digital defects

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