The Anatomic Basis of the Fourth Dorsal Metacarpal Flap: A Cadaveric Dissection

Multislice Computed Tomography Angiography of the Fourth Dorsal Interosseous Space in Cadavers

“…(Figs. 4,5). In all specimens studied, the 4th dorsal metacarpal artery was identified under the fascia of the dorsal interosseous muscle.…”

“…The skin paddle was designed over the 4th dorsal metacarpal space and the dissection performed as described previously. 4,5 Once the perforator vessels were isolated, they were traced back to the source vessel through the dorsal interosseous fascia; the fascia was opened longitudinally, subfascial dissection was performed, the perforators were traced back, and the dorsal metacarpal artery was widely exposed without jeopardizing the vascular elements. The number of perforators and their origin from the source vessel were recorded and measured from a reference point: the carpal-metacarpal joint for perforators located in the proximal half of the hand and the metacarpalphalangeal joint for those located in the distal half.…”

“…We have demonstrated that this space has a constant vascular system with some perforators branching off the metacarpal artery. 4,5 The purpose of this investigation was to evaluate multislice computed tomography angiography (CTA) as a tool for anatomic study of the small vascular network of the hand compared with traditional anatomic dissection.…”

Cutaneous Perforators of the Fourth Dorsal Interosseous Space: Anatomic Study

“…7 The majority of these vessels, however, are direct cutaneous arteries that arise from the distal communicating branch and not from the dorsal metacarpal artery. These distal cutaneous vessels mainly contribute to the vascularization of the skin around the metacarpophalangeal joint.…”

“…The consistency of the dorsal recurrent branch and the dorsal metacarpal artery within the fourth space has been confirmed recently by our group. 7 The conclusion was that there is no need to include the dorsal metacarpal artery in the flap as previously described. 8,9 With the dissection technique used in our previous study, however, we did not find consistent perforators from the dorsal metacarpal artery.…”