title: Planning digital artery perforators using color Doppler ultrasonography: A preliminary report.
abstract: Digital artery perforator (DAP) flaps have been applied for the coverage of finger soft tissue defects. Although an advantage of this method is that there is no scarification of the digital arteries, it is difficult to identify the location of the perforators during intraoperative elevation of the DAP flap. In this study, anatomically reliable locations of DAPs were confirmed using color Doppler ultrasonography (US) in healthy volunteers. A successful case using an adiposal-only DAP flap for the coverage of a released digital nerve using preoperative DAP mapping with color Doppler US is also described. A total of 40 digital arteries in 20 fingers of the right hands of five healthy volunteers (mean age: 32.2 years old) were evaluated. The DAPs were identified using color flow imaging based on the beat of the digital artery in the short axial view. In total, 133 perforators were detected, 76 (an average of 3.8 per finger) arising from the radial digital artery and 57 (an average of 2.9 per finger) arising from ulnar digital artery. Sixty-three perforators (an average of 3.2 per finger) in the middle phalanges and 70 (an average of 3.5 per finger) in the proximal phalanges were found. Overall, an average of 1.7 perforators from each digital artery was detected in the proximal or middle phalanges. Moreover, at least one DAP per phalanx was reliably confirmed using color Doppler US. Preoperative knowledge of DAP mapping could make elevating the DAP flap easier and safer.
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan; Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan. Electronic address: qq355dzt9@msic.med.osaka-cu.ac.jp.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Shintani
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashiyodogawa-Ku, Osaka 533-0024, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Takamatsu
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Uemura
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Ema
authors.initials: E
authors.lastname: Onode
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: Gakuen-minami Clinic, 2-27 Gakuenyamatocho, Nara 631-0041, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kazuki
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000098:blood supply* / Q000000981:diagnostic imaging; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap; D017534:Radial Artery / Q000000981:diagnostic imaging*; D017535:Ulnar Artery / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color
keywords: Color Doppler ultrasonography; Digital artery; Finger; Flap; Perforator