The method of tracing the first dorsal metatarsal artery at the layer superficial to the extensor expansion in thumb and finger reconstruction / 中华创伤骨科杂志

ABSTRACT

Objective To clarify the relationship between the first metatarsal web space and associated vessels and its application in dissection of the toes for thumb and finger reconstruction. Methods The relationships of the first dorsal metatarsal artery to the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaver lower limbs. Clinically 36 cases of thumb defects were reconstructed using the method of tracing the first dorsal metatarsal artery around the space of extensor expansion to dissect toes. Results The distal segment of the first dorsal metatarsal artery of Gilbert type I and type Ⅱwas located superficially to the layer of the extensor expansion.The time of harvesting the toe was shortened from 90 minutes to 50 minutes with 100%survival of reconstruction. Conclusions The distal segment of the first dorsal meatarsal artery lies constantly to the superficial layer of the extensor expansion.Consequently the location of the first metatarsal artery of Gilbert type I and type Ⅱbecomes much easier, by adopting the method of combination of sequential dissection and reverse dissection around the space of the extensor expansion.