Abstract：Objective To dissect and measure the terminal dorsal cutaneous branches of digital inherent artery in fresh hand specimens. Then explore the therapeutic effect of island flap based on terminal dorsal cutaneous branches of digital inherent artery to repair defect at the same or adjacent finger.Methods From May 2011 to May 2014, the origin, courses and distribution of terminal dorsal cutaneous branches of digital inherent artery from 10 fresh hand specimens were perfused by using red latex. Fifty-eight fingers in 49 cases with skin defects were treated with island flap based on terminal dorsal cutaneous branches of digital inherent artery for skin defect at the same or adjacent finger in Department of Hand Surgery of the Second Hospital of Tangshan. There were 21 index fingers, 12 middle fingers, 16 ring fingers and 9 little fingers. The size of the flaps ranged from 10 mm×8 mm to 22 mm×18 mm.Results The distal dorsal branch lay at the neck of the middle phalanx, namely the terminal dorsal branch. All flaps of 49 cases survived successfully. The 6-29 months′ follow up showed that all these flaps recovered with satisfying texture, grade S3+ sensation,and 6-9 mm two point discrimination. There were no obvious complications of the donor site.Conclusions It does not sacrifice the major artery and can restore good flap contour by using the flap based on terminal dorsal cutaneous branches of digital inherent artery to repair the defect at end of finger. The treatment of finger cutaneous defect with the flap is recommendable. It can be easily and conveniently performed.
张文龙，赵刚，高顺红，于志亮，张云鹏，张净宇，胡宏宇，董慧双，于俊. 指固有动脉终末背侧支皮瓣修复指端缺损的显微解剖研究及临床应用[J]. 中华解剖与临床杂志, 2015, 20(5): 418-421.
Zhang Wenlong, Zhao Gang, Gao Shunhong, Yu Zhiliang, Zhang Yunpeng, Zhang Jingyu, Hu Hongyu, Dong Huishuang, Yu Jun. Anatomy study and clinical application of island flap based on terminal dorsal cutaneous branches of digital inherent artery. Chinese Journal of Anatomy and Clinics, 2015, 20(5): 418-421.
Kawakatsu M, Ishikawa K. Dorsal digital perforator flap for reconstruction of distal dorsal finger defects[J]. J Plast Reconstr Aesthet Surg, 2010, 63(1): e46-50.
Deal DN, Barnwell J, Li Z. Soft-tissue Coverage of complex dorsal hand and finger defects using the turn over adipofascial flap[J]. J Reconstr Microsnrg, 2011, 27(2): 133-138.
Betelli JA, Pagliei A. Direct and reversed flow proximal phalangeal island flaps[J]. J Hand Surg Am, 1994, 19(4): 671-680.
[13]
Braga-Silva J, Kuyven CR, Fallopa F, et al. An anatomical Study of the dorsal cutaneous branches of the digital arteries[J]. J Hand Surg Br, 2002, 27(6): 577-579.
[14]
Rui Y, Mi J, Shi H, et al. Free great toe wrap-around combined with second toe medial flap for reconstruction of completely degloved fingers[J]. Microsurgery, 2010, 30(6): 449-456.
[15]
Tellioglu AT, Sensz O. The dorsal Branch of the digital never: an anatomic study and clinical applications[J]. Ann Plast Surg, 1998, 40(2): 145-148.
[16]
Bogov A, Mullin R, Kubitskiy A. The double flap partial reconstruction technique for the avulsion-type finger injuries: a case report[J]. J Hand Surg Eur, 2011, 36(5): 423-425.
[17]
Dabernig J. Re: use of a dorsal adipofascial flap for reconstruction of large volar finger defects[J]. J Hand Surg(Eur Vol), 2008, 33(4): 541.
[18]
Fejjal N, Belmir R, El Mazouz S, et al. Reversed cross finger subcutaneous flap: a rapid way to cover finger defects[J]. Indian J Plast Surg, 2008, 41(1): 55-57.
[19]
del Pinal F, García-Bernal FJ, Cagigal L, et al. Late salvage of the ischemic finger after crush injury using flow-through flaps: case report[J]. J Hand Surg Am, 2009, 34(3): 453-457.
[20]
Kim KS, Yoo SI, Kim DY, et al. Fingertip reconstruction using a volar flap based on the transverse palmar branch of the digital artery[J]. Ann Plast Surg, 2001, 47(3): 263-268.
2015, Vol. 20 
