Karacalar A, Akin S, Ozcan M
Department of Plastic and Reconstructive Surgery, Medical Faculty of Uludağ University, Bursa, Turkey.
Br J Plast Surg. 1996 Mar;49(2):97-102. doi: 10.1016/s0007-1226(96)90081-8.
A flap with double pivot points based on the second dorsal metacarpal artery was used in 13 cases with no complete failures. In 2 cases, the branches of the radial nerve were included in the flap. In 1 case, the flap was used as a tenocutaneous flap with a segment of the extensor indicis proprius tendon. To obtain a flap with double pivot points, the dissection of the vascular pedicle of a distally based second dorsal metacarpal flap is continued proximally under the second dorsal metacarpal artery up to its origin. In this flap the main pivot point coincides with the origin of the SDMA and the second pivot point with the entry point of the recurrent cutaneous branch into the flap. We found this flap to be very versatile, reliable, and quite easy and quick to raise. We report our experience with this flap as a very useful addition to reconstructive procedures, especially for thumb defects.
应用以第二掌背动脉为蒂的双枢轴点皮瓣修复13例，无一例完全失败。2例皮瓣包含桡神经分支。1例将皮瓣用作带有一段示指固有伸肌腱的腱皮瓣。为获得双枢轴点皮瓣，在第二掌背动脉下向近端继续解剖以远端为蒂的第二掌背皮瓣的血管蒂直至其起点。在该皮瓣中，主要枢轴点与第二掌背动脉起点一致，第二枢轴点与皮瓣中返支皮支的进入点一致。我们发现该皮瓣用途广泛、可靠，且切取非常简便快捷。我们报告了应用该皮瓣的经验，认为它是重建手术尤其是拇指缺损修复中非常有用的补充方法。
