Role of the first dorsal metacarpal artery in the construction of pedicled bone grafts (27.3.92)

Bertelli, Jayme Augusto; Pagliei, A.; Lassau, J. P.

doi:10.1007/bf01794953

Cited by 21 publications

(22 citation statements)

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“…Youssif 's 28 description of the 1DMA arising from the dorsal and palmar arterial arches was not confirmed by us nor by other authors 15,17,20,25,29,30 . Hamdy 20 observed the division of 1DMA into 3 branches.…”

Section: Resultsmentioning

confidence: 67%

Anatomic study of the dorsal arterial system of the hand

et al. 2004

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Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries.METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distalbased U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS:The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation.CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.

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Section: Resultsmentioning

confidence: 67%

Anatomic study of the dorsal arterial system of the hand

et al. 2004

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“…Our finding that the LTA mean diameter was 0.67 mm, comparing to the 1 mm on average [1], and that its cutaneous vascular territory over the lateral third of the thenar eminence was constant, suggests the possibility to proximally raise a fasciocutaneous flap based on LTA at its point of origin from RA. Area of skin that could be used as a flap supplied by LTA may be extended by its anastomotic channels with adjacent cutaneous branches of the SPB of the RA.…”

Section: Discussionmentioning

confidence: 67%

“…However, in the literature we found similar descriptions of the LTA, and no data on the MTA. The same area has been studied previously by two authors [1,12]. Bertelli et al [1,2] studied 'the first dorsal metacarpal artery' with clinical application as a donor site for a vascularised bone graft in scaphoid bone non-union.…”

Section: Discussionmentioning

confidence: 97%

“…The same area has been studied previously by two authors [1,12]. Bertelli et al [1,2] studied 'the first dorsal metacarpal artery' with clinical application as a donor site for a vascularised bone graft in scaphoid bone non-union. Moschella and Cordova [12] reported 'the dorsal radial digital collateral artery' following the radial side of the thumb, and they proposed the reverse pedicled skin flap on this artery as a useful option for repairing the thumb.…”

Section: Discussionmentioning

confidence: 97%

“…Only a few articles have been devoted to the cutaneous blood supply of the thenar eminence itself [4,13,16], and there are only scarce data available on the clinical importance of the collateral branches of the radial artery (RA) within the A. Zekavica et al, Arteries of the thenar eminence anatomical snuff-box [7,9,18]. To our knowledge, there are only 3 articles in the literature which partly address the microanatomy of the RA branches in this region [1,2,14].…”

Section: Introductionmentioning

confidence: 99%

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