title: The first metatarsal web space: its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction.
abstract: 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.
authors.affiliation: Department of Orthopaedics, Kunming Military General Hospital, Kunming, China. xuyongqing@163.net
authors.forename: Yong-Qing
authors.initials: YQ
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Shi-Zhen
authors.initials: SZ
authors.lastname: Zhong
authors.forename: Da-Chuan
authors.initials: DC
authors.lastname: Xu
authors.forename: Xiao-Shan
authors.initials: XS
authors.lastname: Xu
authors.forename: Yuan-Fa
authors.initials: YF
authors.lastname: Guo
authors.forename: Xin-Min
authors.initials: XM
authors.lastname: Wang
authors.forename: Zhu-Yi
authors.initials: ZY
authors.lastname: Li
authors.forename: Yue-Liang
authors.initials: YL
authors.lastname: Zhu
mesh_terms: 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*