Arterial Blood Supply of the Extensor Apparatus of the Long Fingers

Kostopoulos, Epameinondas; Casoli, Vincent; Verolino, Pasquale; Papadopoulos, Othon

doi:10.1097/01.prs.0000218799.33322.7f

Cited by 15 publications

(14 citation statements)

References 23 publications

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“…These complexes are perforators derived from the proper digital artery, disposing a main trunk and whose branches vascularize the skin, the extensor apparatus, and the underlying periosteum of the fingers. 18 Their location has been demonstrated to be constant in either side (both radial and ulnar) in relation to the digital joints (MCP, PIP, and DIP). These measurements allowed for the identification of perforators' origins with safety, designing DAP flaps in a predictable pattern without the use of a Doppler device.…”

Section: Anatomymentioning

confidence: 99%

“…This mark was based on the results of the detailed vascular mapping (see Tables 1 and 2) from our previous study. 18 Subsequently, the PPDAP flap was designed on the mid-lateral side of the digit. Following lesion extirpation, the flap was incised along with a vertical incision dorsally, which corresponded to the projection of the VCTOC origin, facilitating its dissection (see Figure 3b).…”

Section: Surgical Techniquementioning

confidence: 99%

“…Almost at the same time the senior authors in a detailed anatomical work concerning the arterial blood supply of the extensor apparatus of the fingers 18 described the vascular cutaneo-tendino-osseous complex (VCTOC). These complexes (see Tables 1 and 2), based on perforators originating from the proper digital arteries, vascularize not only the extensor apparatus, but also all anatomical elements of the fingers.…”

Section: Introductionmentioning

confidence: 99%

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Predictable Pattern Digital Artery Perforator Flap

Kostopoulos

Agiannidis

Konofaos

et al. 2016

Hand (New York, N,Y.)

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Background: The proper digital arteries as any other axial vessel give rise to multiple cutaneous perforators either volar or dorsal along their course. Their identification is performed with Doppler flowmetry. The vasculo-cutanotendino-osseous complex (VCTOC), which was described by the senior authors, was responsible for the vascularization of all digital anatomic structures (extensor apparatus, skin, periosteum). Their consistent appearance to well measured distances from the digital joints led the way to the present clinical study for highlighting this described anatomy in-vivo and demonstrating the predictability in digital artery perforator (DAP) flap harvest. Methods: From November 2012 to March 2014, fifteen patients underwent reconstruction with a predictable pattern digital artery perforator flap (PPDAP), based on the previously described VCTOC mapping, for digital lesions secondary to tumor extirpation. Flaps were designed as V-Y advancement or propeller type. Postoperative control concerned flap viability and digital function. Results: Seven males and 8 females underwent elective surgery using PPDAP flaps for digital defects following tumor extirpation. The diameter of the defect ranged from 0.5 to 1.5 cm. The vast majority of the lesions were identified on the right hand, the index, the ring finger and the distal phalanx. All flaps survived without signs of venous congestion. No functional digital problems were observed during follow up (mean of 77 months). A minor wound dehiscence presented in one patient. Conclusions: Authors introduced the concept of a "predictable pattern" in the surgery of perforator flaps in the digits. These flaps are reliable and could be a valuable reconstructive option.

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Section: Anatomymentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictable Pattern Digital Artery Perforator Flap

Kostopoulos

Agiannidis

Konofaos

et al. 2016

Hand (New York, N,Y.)

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“…Small branches of the digital nerves accompany also the vascular network (1). Kostopoulos et al described the vascular cutaneotendino-osseous complex, which originates from the proper digital arteries and is responsible of the vascularization of skin, extensor apparatus and periosteum (4,5).…”

Section: Anatomical Considerationsmentioning

confidence: 99%

“…Knowing the existence of the so called vascular cutaneotendino-osseous complex described by Kostopoulos et al (4,5), it is evident that a complex defect affecting also the extensor apparatus can be reconstructed by using a composite flap including a small slip of vascularized tendon (Figures 8,9).…”

Section: Stepmentioning

confidence: 99%

Propeller perforator flaps for finger reconstruction

Georgescu¹,

Matei²

2018

J. Xiangya Med.

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Replacement of lost skin of fingers, especially fingertips, can be extremely difficult, often requiring a distant regional or even microvascular tissue transfer. However, these are rarely tissues of similar qualities which may not provide the same function as those that had been lost. A better alternative that can even be simpler to obtain is to use tissues remaining adjacent to the defect, based on finger fascial perforators. Often, if moved in a propeller fashion, not only can the defect be closed but also the donor site itself, thereby avoiding the functional as well as aesthetic disadvantages of a skin graft.

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