Abstract:

        Objective   To provide applied anatomic evidences for the application of the dorsal metacarpal and digital fasciocutaneous flap pedicled with the dorsal cutaneous branch of the proper digital artery.  Methods  14 fresh adult cadaveric hands were injected with red latex. The dorsal digital and metacarpal vessels of the cadaveric hands were dissected layer by layer, and their course, distribution, connection and external diameter were observed and measured with the aid of an operating microscope.  Results   There were 1 to 7 indirect dorsal cutaneous branches and 2 to 8 direct dorsal cutaneous branches of the proper digital artery in each side of proximal and middle phalanx, respectively. There was a relatively large dorsal cutaneous branch of the digital artery in each side of the middle and distal third of the proximal phalanx, the proximal or middle third of the second phalanx, respectively, whose external diameters were more than 0.3 mm usually. The dorsal digital branches of the terminal segment of dorsal metacarpal artery and distal dorsal perforator of deep palmar arch anastomosed with the dorsal cutaneous branches of the digital artery. The dorsal cutaneous branches of the digital artery in different segments anastomosed with each other at the dorsolateral aspect of phalanx, where a arterial link was formed.  Conclusions   The reverse dorsal metacarpal and digital fasciocutaneous flap pedicled with the dorsal cutaneous branch of the proper digital artery is more suitable for repairing comparatively large-area soft tissue defects of middle and distal phalanx, for their advantages of easy and secure harvest, and the longer arch of rotation.

Key words:  Fasciocutaneous flap, Dorsal metacarpal artery, Cutaneous branch, Applied anatomy