Tranquilli-Leali or Atasoy flap: an anatomical cadaveric study.
BACKGROUND
The Tranquilli-Leali and Atasoy volar V-Y advancement flaps are considered workhorse flaps in the reconstruction of fingertip amputations. However, their description in the literature in terms of surgical dissection and blood supply is often indistinct. This study describes the differences between the two flaps and highlights their unique blood supply based on a thorough cadaveric study and review of the literature.


METHODS
Using 16 fresh cadaveric fingers, eight Tranquilli-Leali and eight Atasoy volar V-Y advancement flaps were dissected, mapping the arterial blood supply using an injectable blue resin. In addition, a thorough literature search on the subject was done.


RESULTS
In all eight fingertips dissected as decribed by Tranquilli-Leali, the flap was supplied by the anastomotic connections between the terminal branches of the palmar digital arteries and dorsal nail-bed arcades via the fibro-osseous hiatus. In contrast, in all eight fingertips which were dissected as described by Atasoy, the flaps were perfused through the terminal branches of the palmar digital arteries.


CONCLUSIONS
The Tranquilli-Leali and Atasoy volar V-Y advancement flaps, used to reconstruct fingertip amputations, are distinct from one another in several ways. The most obvious difference is their technique of flap dissection, which, in turn, dictates a unique blood supply. Through careful dissection and a review of the literature, this anatomical study has brought to light the specific vascular supply to each flap that was evaluated.
Gharb
Bahar Bassiri
BB
Via Bosco dell'orco, 12/4, 30033 Noale (Ve), Italy.
Rampazzo
Antonio
A
Armijo
Bryan S
BS
Eshraghi
Yashar
Y
Totonchi
Ali S
AS
Teo
Tiew Chong
TC
Salgado
Christopher J
CJ
D002102:Cadaver; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D008953:Models, Anatomic; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*