First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits
First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits
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第一掌背动脉穿支螺旋桨皮瓣：功能解剖学及在手背和手指软组织缺损中的临床应用
DOI：
10.1007/s00276-021-02845-z
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发表时间：
2021
影响因子：
1.4
通讯作者：
Kobayashi Yasushi
中科院分区：
文献类型：
--
作者：
Aizawa Tetsushi;Hirayama Takahiro;Kiyosawa Tomoharu;Kobayashi Yasushi
背景：应用掌背动脉皮瓣修复手部软组织缺损的方法有多种。从第一掌骨间隙到手背的穿支螺旋桨皮瓣的使用已经被描述过。本研究的目的是确认第一掌背动脉（FDMA）穿支皮瓣的功能解剖。MethodsTwenty-nine固定尸体手解剖，以确定的起源，过程和分支的FDMA。临床上，5例软组织缺损的手进行重建手术，使用FDMA穿孔为基础的螺旋桨flaper.ResultsThe FDMA被发现在27个标本（93%）。皮肤穿支均由尺侧支分支提供（平均值±标准差，4.3 ± 1.6），最远侧皮肤穿支分支出现在沿着掌骨长轴，距掌骨头尖端25 mm以内，出现频率较高（28/29，97%）。在两个有发育不全的FDMA的手，发达的穿支直接从桡动脉和先进的掌骨头。7只手（24%）有来自掌动脉系统的穿支，穿过或靠近第二掌骨。临床应用中，所有皮瓣全部成活，无严重并发症。结论：FDMA穿支螺旋桨皮瓣是一种微创，技术简单。有望成为手部再造的新选择。
BackgroundMany approaches have been reported to repair soft-tissue defects of the hand using dorsal metacarpal artery flaps. Use of a perforator-based propeller flap from the first intermetacarpal space to the dorsum of the hand has been described. The aim of this study was to confirm the functional anatomy of a first dorsal metacarpal artery (FDMA) perforator flap.MethodsTwenty-nine fixed cadaveric hands were dissected to determine the origin, course, and branches of the FDMA. Clinically, five cases of soft tissue defects of the hand underwent reconstructive surgery using an FDMA perforator-based propeller flap.ResultsThe FDMA was found in 27 specimens (93%). The ulnar branch of the FDMA always supplied the cutaneous perforator (mean ± SD, 4.3 ± 1.6), and the most distal cutaneous perforating branch was found along the metacarpal long axis within 25 mm of the tip of the metacarpal head with high frequency (28/29, 97%). In the two hands that had aplasia of the FDMA, well-developed perforators arose directly from the radial artery and advanced to the metacarpal head. Seven hands (24%) had perforators arising from the palmar arterial system, penetrating through or passing close by the second metacarpal bone. In clinical application, all the flaps survived completely without major complications.ConclusionsThe FDMA perforator-based propeller flap is minimally invasive and technically simple. It is expected to be a new option for hand reconstruction.
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影响因子：
3.6
作者：
Sebastin, Sandeep J.;Mendoza, Romina T.;Lim, Aymeric Y. T.
通讯作者：
Lim, Aymeric Y. T.
影响因子：
1.9
作者：
Miller, Erin Anne;Friedrich, Jeffrey
通讯作者：
Friedrich, Jeffrey
DOI：
10.1080/23320885.2020.1806069
发表时间：
2020-01-01
影响因子：
0.2
作者：
di Summa, Pietro G.;Davies, Kerry;Hart, Andrew
通讯作者：
Hart, Andrew
影响因子：
1.9
作者：
IKEDA, A;UGAWA, A;HAMADA, N
通讯作者：
HAMADA, N
彩色多普勒超声评估识别第二掌背背皮瓣的穿支动脉
影响因子：
1.6
作者：
M. Nanno;N. Kodera;Y. Tomori;Y. Hagiwara;S. Takai
通讯作者：
S. Takai