Abstract
BackgroundA second dorsal metacarpal artery cutaneous branches flap is often used to repair skin defects in the hand. The location of the cutaneous branch of that artery is very critical for the removal of the flap. In this study, we quantitatively analyzed the origin of the cutaneous branches of the second dorsal metacarpalartery and the distribution characteristics of the radial and ulnar side to provide an anatomical basis for designing a flap.MethodsSixteen upper limb specimens were perfused with latex. Four specimens were infused with ethyl acetate plus plastic, and four specimens were perfused with red latex to create pellucid specimens. The origin, travel paths, and distribution of the cutaneous branches of the second dorsal metacarpal artery were anatomically observed, and we measured the length of the cutaneous branch from the midpoint of the second web space edge. We also measured the diameters and pedicle lengths of the radial and ulnar distributions of cutaneous branches of the second dorsal metacarpal artery.ResultsThe cutaneous branches of the second dorsal metacarpal artery were mainly clustered at three positions, the second cluster point was at 43.9%, the fourth cluster point was at 61.2%, and the fifth cluster point was at 72.1%. The first cluster point was at 30.8% and the sixth cluster point was at 85.6%. The diameter and pedicle length of the sixth cluster point were the largest. There was no significant difference in the distribution of the diameters and pedicle lengths of the cutaneous branch between the radial and ulnar side. The second dorsal metacarpal artery sent out 1–2 cutaneous branches before the tendon joint, and formed a blood vessel anastomosis with other cutaneous branches located further from the tendon joint. The dorsal branch of the radial nerve in the hand extended a nerve branch at the wrist joint and traveled between the cutaneous branches of the second dorsal metacarpal artery to dominate the corresponding skin.ConclusionThree clusters in the distal second dorsal metacarpal artery were selected to be the flap pedicle containing a cutaneous nerve for use in repairing a skin defect in the hand and fingers.
Highlights
The hand is the most commonly used appendage in daily life and the most vulnerable part of the body
All cutaneous branches extending from the second dorsal metacarpal artery were counted in 16 specimens, and a total of 103 branches were identified
The cutaneous branches were mainly clustered at three positions: the second cluster point was at 43.9%, and included branches, the fourth cluster point was at 61.2%, and included dermal branches, and the fifth cluster point was at 72.1%, and included 22 cutaneous branches
Summary
The hand is the most commonly used appendage in daily life and the most vulnerable part of the body. Dorsal metacarpal artery flaps are used to repair hand tissue defects, and especially defects of the fingers. A second dorsal metacarpal artery flap is usually used to cover a hand skin defect. Current research shows that the second dorsal metacarpal skin flap is usually designed so as to allow the second metacarpal dorsal artery to serve as the vascular pedicle when repairing small area skin defects in the hand. A second dorsal metacarpal artery cutaneous branches flap is often used to repair skin defects in the hand. We quantitatively analyzed the origin of the cutaneous branches of the second dorsal metacarpalartery and the distribution characteristics of the radial and ulnar side to provide an anatomical basis for designing a flap
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