Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study.
Branche dorsale du nerf digital palmaire propre
Digital flap
Dorsal branch of the proper palmar digital nerve
First dorsal branch of the proper palmar digital artery
Lambeau digital
Première branche dorsale de l’artère digitale palmaire propre
Journal
Hand surgery & rehabilitation
ISSN: 2468-1210
Titre abrégé: Hand Surg Rehabil
Pays: France
ID NLM: 101681801
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
23
10
2019
revised:
26
03
2020
accepted:
31
03
2020
pubmed:
15
5
2020
medline:
30
9
2021
entrez:
15
5
2020
Statut:
ppublish
Résumé
The pedicled flap from the first dorsal branch of the proper palmar digital artery (FBPPDA) of the fingers is an option for reconstructing digital skin defects. It has the advantage of being innervated by the dorsal branch of the proper palmar digital nerve (DBPPDN) associated with the artery. However, no studies on the anatomical variations of the neurovascular pedicle have been performed yet. The objective of our study was to evaluate the anatomical variations in the neurovascular pedicle, determine its relationships with other anatomical structures, describe the dissection technique for the FBPPDA and explore potential indications. We conducted an anatomical study with eight upper limbs from fresh adult cadavers. Twenty-six fingers (6 index, 6 middle, 8 ring, 8 little) were dissected after intra-arterial silicone injection. We found a pedicle composed of the FBPPDA and the DBPPDN in all fingers. The artery arises an average 19mm from the bifurcation of the common palmar digital artery. The DBPPDN's configuration relative to the FBPPDA varied; in the main variant - found in 58% of cases - the nerve was superficial and proximal position to the artery. After its origin, the pedicle ran on the superficial aspect of the extensor hood along an oblique path from proximal to distal and from palmar to dorsal. Its path ended with its penetration into the skin paddle of the flap just upstream the proximal interphalangeal (PIP) joint. The skin paddle corresponded to the functional skin unit represented by the dorsal surface of the middle phalanx and that of the PIP joint. Its average length was 33mm (26-40) and its average width was 21mm (15-30). The arc of rotation was sufficient to reach homodigital and heterodigital cutaneous defects. Based on our findings, this flap is a reliable and reproducible option for finger skin defects. The size of its paddle and its innervation make it an interesting alternative to conventional flaps.
Identifiants
pubmed: 32408007
pii: S2468-1229(20)30105-5
doi: 10.1016/j.hansur.2020.03.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
431-436Informations de copyright
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