The microsurgical anatomy and transplantation of nailbed flap supplied by fibular branch of first dorsal digital artery of the great toe

Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (6) : 609-613.

Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (6) : 609-613. DOI: 10.13418/j.issn.1001-165x.2019.06.001

The microsurgical anatomy and transplantation of nailbed flap supplied by fibular branch of first dorsal digital artery of the great toe

  • LIU Ming-bo, LI Bao-long,YE Wei-de,HU Wei,LANG Yong,ZHANG Zi-qing, WANG Da-ping,ZHU Wei-min
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Abstract

Objective To provide anatomic basis for the clinical design of the pedicle flap of the fibular branch of first dorsal digital artery. Methods Fifteen fresh foot specimens (The left side was 6 cases, the right side was 9 cases, 11 males and 4 females)were used for red latex infusion. The origins, flowing patterns, distribution patterns and characteristics of the fibular branch of first dorsal digital artery of the great toe were analyzed. Results The fibular branch of first dorsal digital artery of the great toe was found. According to the origin, it was divided into 3 types:  Type I. The fibular branch of first dorsal digital artery of the great toe was released from the inside of the first dorsal metatarsal artery for 9 cases which was accounting for 60.00 %, with the initial diameter ( 1.21±0.34. ) mm;  Type II, The fibular branch of first dorsal digital artery in the proximal phalanx was originated from the lateral of the plantar artery on fibular side of great toe for 3 cases,which was accounting for 20.00 %, with the initial diameter (1.13 ± 0.26) mm;  Type III, The fibular branch of first dorsal digital artery was distributed by the first dorsal metatarsal artery and the plantar artery on fibular side of great toe in the proximal phalanx for 3 cases which was accounting for 20.00 %. According to the branch thickness, the type III can be divided into three subtypes: Type IIIa, 1 case,The branch of the first dorsal metatarsal artery was preponderance, accounting for 6.67%, the diameter of the branch of the first dorsal metatarsal artery at starting point was 0.82 mm, and the diameter of the branch of the plantar artery on fibular side of great toe at the starting point was 0.53 mm. Type IIIb, 1 case The branch of the plantar artery on fibular side of great toe was preponderance, accounting for 6.67. %, the diameter of the branch of the first dorsal metatarsal artery at starting point was 0.51 mm, the diameter of the branch of the plantar artery on fibular side of great toe at the starting point was 0.71 mm; Type IIIc, 1 case the branch of the first dorsal metatarsal artery and the branch of the plantar artery on fibular side of great toe were isometrically (generally contracted), accounting for 6.67%, the diameter of the branch of the first dorsal metatarsal artery at starting point was 0.41mm, and the diameter of the branch of the plantar artery on fibular side of great toe at the starting point was 0.43mm. All types of the fibular branch of first dorsal digital artery extended into the nail bed, and there were skin branches to nourish the upper nail and the temporal side. Conclusions The pedicle flap of the fibular branch of first dorsal digital artery is easy to be transplant and repair the nail bed defect. This procedure has the advantages of reliable blood supply, no sacrifice of main blood vessels, safe cutting, and nutritional nerves.

Key words

The fibular branch of first dorsal digital artery /  Nailbed flap /  Microscopic anatomy / Tissue transplantation  /  

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The microsurgical anatomy and transplantation of nailbed flap supplied by fibular branch of first dorsal digital artery of the great toe[J]. Chinese Journal of Clinical Anatomy. 2019, 37(6): 609-613 https://doi.org/10.13418/j.issn.1001-165x.2019.06.001

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