title: The second dorsal metacarpal artery chain-link flap: an anatomical study and a case report.
abstract: OBJECTIVE
  The purpose of this study was to discuss the distribution characteristics and the anatomical angioarchitecture of cutaneous branches arising from the second dorsal metacarpal artery for the repair of small tissue defects in the hand or fingers using the second dorsal metacarpal artery chain-link flap.
  
  
  METHODS
  Fifteen fresh human cadaveric hands were studied using three methods: latex perfusion for microanatomical analysis, denaturation of material and vinyl chloride mixed packing for cast specimens, and latex perfusion creating pellucid specimens. Cutaneous perforators with a diameter of 0.2 mm or greater were evaluated using statistical analysis. Cluster analysis was conducted to determine the overall distribution of the perforators.
  
  
  RESULTS
  Two main clusters of perforators distributed at a relative distance of 40.8 and 68.6% from the second web space edge to the midpoint of the second metacarpal bone as a unit. The Chi-square analysis revealed no significant differences in either the radial or ulnar side distribution of the cutaneous perforators from the second dorsal metacarpal artery (p = 0.779). Chain-links formed among adjacent perforators were parallel to the axis of the second metacarpal bone on the dorsum of the hand. Based on the anatomic characteristic, we designed the second dorsal metacarpal artery chain-link flap to recover the defect in the index finger. As a result, the patient was satisfied with the appearance and function.
  
  
  CONCLUSIONS
  This study indicates that there are two main clusters of arterioles in the distal second dorsal metacarpal artery that can be helpful for the second dorsal metacarpal artery pedicle cutaneous chain-link perforator flaps in the repair of defects in the fingers.
authors.affiliation: Department of Anatomy, Southern Medical University, Guangzhou, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Xiangzheng
authors.initials: X
authors.lastname: Qin
authors.forename: Huifeng
authors.initials: H
authors.lastname: Zhang
authors.forename: Chao
authors.initials: C
authors.lastname: Sun
authors.forename: Youmao
authors.initials: Y
authors.lastname: Zheng
authors.forename: Yafei
authors.initials: Y
authors.lastname: Xu
authors.forename: Zihai
authors.initials: Z
authors.lastname: Ding
mesh_terms: D000328:Adult; D002102:Cadaver; D016000:Cluster Analysis; D005260:Female; D005385:Fingers / Q000033:anatomy & histology / Q000098:blood supply* / Q000601:surgery*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000033:anatomy & histology / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*; D017535:Ulnar Artery / Q000033:anatomy & histology*