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Dorsal metacarpal reverse flaps. Anatomical basis and clinical application
Journal of Hand Surgery (Edinburgh, Scotland)
|November 1, 1991
Summary
Distally-based cutaneous island flaps can be reliably raised from the dorsal hand using reverse-flow vascularization via distal intermetacarpal anastomoses. These flaps are ideal for reconstructing defects on the proximal phalanx and joint.
Area of Science:
- Anatomy
- Surgical Reconstruction
- Vascular Anatomy
Background:
- The dorsal and palmar vascular networks of the hand are interconnected.
- Understanding these connections is crucial for reconstructive surgery.
Purpose of the Study:
- To investigate the consistent presence and location of distal intermetacarpal anastomoses.
- To evaluate the feasibility of raising distally-based cutaneous island flaps for hand reconstruction.
Main Methods:
- Anatomical study using 35 adult cadaver hands.
- Identification and mapping of distal intermetacarpal anastomoses between dorsal and palmar vascular networks.
- Assessment of flap-raising potential based on vascular supply.
Main Results:
- Distal intermetacarpal anastomoses were consistently identified in all cadaver hands.
- The precise location of these anastomoses varied with the dorsal metacarpal artery's course.
- This vascular pattern supports the reliable elevation of distally-based island flaps.
Conclusions:
- Distally-based cutaneous island flaps, supplied by reverse-flow vascularization through distal intermetacarpal anastomoses, can be consistently raised.
- These flaps are suitable for covering dorsal defects of the proximal phalanx and proximal interphalangeal joint.