Vascular basis of dorsal digital and metacarpal skin flaps

We studied the vascular anatomy of dorsal digital skin flaps and the vascul ar anastomoses between the dorsal cutaneous branch of the palmar digital ar tery (PDA) and the dorsal digital branches (the terminal branches) of the d orsal metacarpal artery (DMA) at the level of the proximal phalanx. Eight f resh cadavers (16 hands) were injected with a lead oxide-gelatin mixture. O ur radiographic assessment revealed that there were 2 sources of the arteri al supply to the dorsum of the digit, the dorsal digital branches of the DM A, and the dorsal cutaneous branches of the PDA. These branches anastomose with each other. A flap including the territory of the dorsal cutaneous bra nches of the PDA and a part of the territory of the DMA can be harvested on the dorsal aspect of the proximal and middle phalanges. The extended neuro vascular island flap, based on the PDA and the dorsal branch of digital ner ve, can be transposed to the volar surface of an adjacent finger resurfacin g the entire length of the digit. (J Hand Surg 2001;26A:142-146. Copyright (C) 2001 by the American Society for Surgery of the Hand.).