title: Color Doppler ultrasound assessment for identifying perforator arteries of the second dorsal metacarpal flap.
abstract: The second dorsal metacarpal (SDMC) perforator flap has been widely used for the soft tissue reconstruction of the hand. However, it is difficult to identify the depth and branches of the perforators of the second dorsal metacarpal artery (SDMA) using only handheld acoustic Doppler flowmetry (HADF), which is the most common method. The purpose of this study was to compare the results of examination by color Doppler ultrasonography (CDU) with those of HADF and to evaluate the efficacy of CDU for detection of the perforators to be used in the design of the SDMC flap.
  
  
  
  Twenty-two healthy volunteers (42 hands) were examined using both CDU and HADF. All locations identified as the perforators of the SDMA by the two examinations were mapped respectively.
  
  
  
  The total perforator arteries detected with CDU in all hands were 111 branches, 49 branches of which could not be identified with HADF. The average number of perforators of the SDMA per hand found with CDU was 2.8 branches, while that for HADF was only 1.8 branches. The detection rates of the cutaneous perforators of the SDMA by CDU were 100% in the proximal one-third of the second metacarpal and 95% in the distal one-fourth of the second metacarpal.
  
  
  
  This study demonstrated the superiority of CDU compared with HADF for detection of the perforators of the SDMA. The CDU examination could easily identify the locations of the cutaneous perforators and help in the useful assessment of vascularity for the SDMC flap.
authors.affiliation: Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Nanno
authors.affiliation: Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Kodera
authors.affiliation: Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tomori
authors.affiliation: Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hagiwara
authors.affiliation: Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Shinro
authors.initials: S
authors.lastname: Takai
mesh_terms: D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008663:Metacarpus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
keywords: color Doppler ultrasonography; handheld acoustic Doppler; perforator artery; second dorsal metacarpal flapflowmetry