Anatomy study and clinical application of island flap based on terminal dorsal cutaneous branches of digital inherent artery

Abstract

Objective To dissect and measure the terminal dorsal cutaneous branches of digital inherent artery in fresh hand specimens. Then explore the therapeutic effect of island flap based on terminal dorsal cutaneous branches of digital inherent artery to repair defect at the same or adjacent finger. Methods From May 2011 to May 2014, the origin, courses and distribution of terminal dorsal cutaneous branches of digital inherent artery from 10 fresh hand specimens were perfused by using red latex. Fifty-eight fingers in 49 cases with skin defects were treated with island flap based on terminal dorsal cutaneous branches of digital inherent artery for skin defect at the same or adjacent finger in Department of Hand Surgery of the Second Hospital of Tangshan. There were 21 index fingers, 12 middle fingers, 16 ring fingers and 9 little fingers. The size of the flaps ranged from 10 mm×8 mm to 22 mm×18 mm. Results The distal dorsal branch lay at the neck of the middle phalanx, namely the terminal dorsal branch. All flaps of 49 cases survived successfully. The 6-29 months' follow up showed that all these flaps recovered with satisfying texture, grade S3+ sensation, and 6-9 mm two point discrimination. There were no obvious complications of the donor site. Conclusions It does not sacrifice the major artery and can restore good flap contour by using the flap based on terminal dorsal cutaneous branches of digital inherent artery to repair the defect at end of finger. The treatment of finger cutaneous defect with the flap is recommendable. It can be easily and conveniently performed. Key words: Soft tissue injuries; Finger injuries; Surgical flaps; Reconstructive surgical procedures