Anatomy-based application of finger fascia pedicled skin artery branches flap.

Objectives: To study the anatomy of the dorsal metacarpal arteries and their branches, to understand the positions and shapes of the arteries and their branches, and to observe the capillary network formed on the lateral and the dorsal sides of the finger under a microscope. Based on this anatomy, a finger fascia pedicled skin artery branch flap was designed to repair fingertip wounds.

Methods: A total of 5 fresh adult cadaveric hand specimens were infused with red latex. The anatomy of the dorsal finger intrinsic arteries of the 40 fingers (excluding the thumbs) were observed under a microscope, and a capillary network was formed on the lateral and the dorsal sides of the fingers. Then, 10 cases of finger soft tissue defects were repaired using an anatomy-based design finger fascia pedicled skin artery branch flap.

Results: The anatomical observations indicated that the intrinsic artery on each side of the finger sends four thicker cutaneous branches toward to the dorsal side, wherein the descending branch of the upper cutaneous branch coincides with the ascending branch of the next cutaneous branch to form a lateral vascular chain. A fascia flap pedicled (>0.5 cm) skin artery branch flap was used to repair the patients' finger injuries (8 males and 2 females, aged 21 to 52 years). The wound surface ranges were about 2.8 cm × 1.9, and the flap ranges were about 3 cm × 2.1 cm. During the 5-12 months of follow-up, all the flaps survived well.

Conclusion: The bilateral finger arteries emit a number of macroscopically identifiable capillary branches and form a capillary network using anastomosis between the cutaneous branches. The finger fascia pedicled skin artery branches flap, not <0.5 cm wide, contains the capillary branch of the dorsal finger artery as the flap for the blood supply. The flap can cover various types of distal finger wounds.