Variations in Innervation Pattern to Dorsum of Foot by Medial Dorsal Cutaneous Nerve, Intermediate Dorsal Cutaneous Nerve, Lateral Dorsal Cutaneous Nerve with Surgical and Clinical Correlations: A Cadaveric Dissection Based Study

The complete reconstruction of any soft tissue defect includes even the sensory recovery which is very significant aspect pertaining to prognosis. Superficial nerves in the vicinity of the vascular axis can be considered as vascular relays and neuroskin grafts can be constructed on them. Variations in innervation to various part of the dorsum of the foot by this nerve should be kept in mind while making these grafts. Authors dissected 50 formalinized cadaveric feet and studied normal anatomy and variations in origin, course, branching pattern, communications, and any other variations in medial, intermediate and lateral dorsal cutaneous nerve. The intermediate dorsal cutaneous nerve was innervating larger area of the skin around 3rd and 4th web spaces in 60% of cadaveric feet. The 2nd web space was innervated by medial dorsal cutaneous nerve in 92% of cadaveric feet. In 52% of cadaveric feet communicating branches were found between intermediate dorsal cutaneous nerve and lateral dorsal cutaneous nerve. In 63% cadaveric feet communicating branches were found between medial dorsal cutaneous nerve and branch of deep peroneal nerve to 2nd web space. The mean distance between lateral malleolus and intermediate dorsal cutaneous nerve was 4.05cm. These all observations can provide anatomical basis at the time of preparing medial dorsal cutaneous nerve flaps and intermediate dorsal cutaneous nerve flaps and also can minimize morbidity at donor site.

Retrograde neurocutaneous flap to repair dorsal skin defect of fingers / 中国矫形外科杂志

[Objective]To research the method to repair dorsal skin defect of fingers by using retrograde neurocutaneous flap.[Method]Adopting nutrient vessels of 4 nerve branches in hands of radial-ulnar nerve as pedicle,the flaps were designed and applied to repair dorsal skin defect of fingers.[Result]All 10 flaps in 5 cases survived and wound area were covered.[Conclusion]Retrograde neurocutaneous flaps have sufficient blood supply,with no injury to nominous vesels,and with long distance to repair.Therefore,it is an advantageous method to repair dorsal skin defect,futhermore,two flaps could be used to repair skin defect of two fingers at the same time.