The first metatarsal web space: its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction.
OBJECTIVE
To clarify the anatomical relationship of the structures in the first toe webbing space for better dissection of toes in thumb reconstruction.


METHODS
The first dorsal metatarsal artery, the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaveric lower extremities. Clinically the method of tracing the first dorsal metatarsal artery around the space of the extensor expansion was used in 36 cases of thumb reconstruction.


RESULTS
The distal segments of the first dorsal metatarsal artery of Gilbert types I and II were located superficially to the extensor expansion. The harvesting time of a toe was shortened from 90 minutes to 50 minutes with 100% survival of reconstructed fingers.


CONCLUSIONS
The distal segment of the first dorsal metatarsal artery lies constantly at the superficial layer of the extensor expansion. Most of the first metatarsal arteries of Gilbert types I and II can be easily located via the combined sequential and reverse dissection around the space of the extensor expansion.
Xu
Yong-Qing
YQ
Department of Orthopaedics, Kunming Military General Hospital, Kunming, China. xuyongqing@163.net
Li
Jun
J
Zhong
Shi-Zhen
SZ
Xu
Da-Chuan
DC
Xu
Xiao-Shan
XS
Guo
Yuan-Fa
YF
Wang
Xin-Min
XM
Li
Zhu-Yi
ZY
Zhu
Yue-Liang
YL
D000293:Adolescent; D000328:Adult; D002648:Child; D004210:Dissection; D005383:Finger Injuries / Q000601:surgery; D006801:Humans; D008684:Metatarsus / Q000033:anatomy & histology* / Q000098:blood supply; D019651:Plastic Surgery Procedures; D013933:Thumb / Q000293:injuries* / Q000601:surgery*