Arterial anatomy of the second toe nail bed related to toenail transfer.
The aim of this study was to elucidate the exact course of the terminal branches of the plantar digital artery (PDA) to the nail bed of the second toe. Thirteen second toes from seven fresh Korean cadavers were dissected (age range 74-92 years, four men and three women). The terminal segmental branches (TSB) branched off from the PDA at 7.6 ± 0.7 mm proximal to the nail fold. The fibro-osseous hiatus branch (FHB) branched off from the PDA at 3.3 ± 0.7 mm from the nail fold. They were 3.8 ± 1.0 mm lateral to the paronychium. Diameters of TSB and FHB were 0.8 ± 0.2 mm and 0.7 ± 0.1 mm, respectively. Diameter of PDA was 1.4 ± 0.2 mm. Surgeons should stay at least 4 mm proximal to the nail fold to avoid injury to the terminal branch. We believe that second toenail with minimum amount of soft tissue may be transferred using FHB-based vascularized toenail flap. Perfusion study and clinical application should be followed.
Hwang
Kun
K
Department of Plastic Surgery, Center for Advanced Medical Education by BK21 Project, Inha University School of Medicine, Incheon, Korea. jokerhg@inha.ac.kr
Ki
Sae H
SH
Choi
Hyuk G
HG
Hwang
Sejin
S
Kim
Dong H
DH
Han
Seung H
SH
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D009262:Nails / Q000098:blood supply* / Q000637:transplantation*; D014034:Toes / Q000098:blood supply*