Vascular anatomic variations in second toe transfers

To devise a new classification of vascular variations in second toe transfe r we analyzed the anatomic details of the first dorsal metatarsal artery in 304 cases of second toe transplantation and the venous structure in 200 ca ses. According to location, the arterial vascularity was classified as supe rficial (18% of cases), intramuscular (54%), inframuscular (23%), and absen t (5%). According to diameter, it was classified into large (16%), medium ( 64%), and small (20%). Based on branching pattern, the artery was classifie d into ramifying type (88%), main trunk (4%), and fine branch type (8%). Th e venous drainage of the second toe was categorized as greater saphenous ve in main trunk type, greater saphenous vein fine branch type, dorsal digital vein main trunk type, and dorsal digital vein fine branch type. Variations of the first dorsal metatarsal artery are common. Classification should be done according to its location, diameter, and branching pattern at the toe web. Regardless of location, big vessels entering the second toe are the m ost important attribute for successful outcome. (J Hand Surg 2000;25A:277-2 81. Copyright (C) 2000 by the American Society for Surgery of the Hand.).