Microanatomy and clinical application of stepladder advancement flap pedicled with the radial proper digital artery of index finger / 中华显微外科杂志

ABSTRACT

Objective To observe the anatomy of the radial proper digital arteries and their dorsal vessels of index fingers, and the relative position and orientation of them were summarized. To explore the surgical method and clinical appilication of the stepladder advancement flap pedicled with the radial proper digital artery of index finger in the finger tip defects. Methods From June, 2013 to June, 2016, 6 hand specimens were injected into the brachial artery with red latex to carry out the microanatomy of the index finger’s radial proper digital arteries and their dorsal vessels. And 1 vascular cast of hand specimen were observed the origin, number and oriention of the artery and its dorsal vessel. Ten cases with soft tissue defects of index finger in finger tip, were repaired with stepladder advance-ment flap pedicled with the radial proper digital artery. The evaluations and analysis were made in survival rate and finger's function by the postoperative regular consultations. Results There were 2 (4 hands) or 3 (2 hands) dorsal vessels in the proximal, and 2(6 hands) in middle segments of the radial proper digital arteries of index fingers in 6 hand specimens respectively. While the vascular cast of hand specimen showed that 3 dorsal vessels in the proximal, and 2 in the middle segments of the radial proper digital artery. Ten patients were performed the operation. The blood flow after the surgery were good and all flaps survived well. Followed-up time was 10-14 months. The color, feeling, contour and texture of flaps was good. The function of flexion and extension of the finger was good too, and no defor-mity of the purlicue. The resolution of static two points was 5.5-9.0 mm, averaged of 7.2 mm. Conclusion The stepladder advancement flap pedicled with the radial proper digital artery of index finger can extend the donor site. It is safe, reliable and effective, providing a alternation for the repair of the soft tissue defects of the index finger tip.