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Investigation of Dorsal Metacarpal Artery Perforator Using Color Doppler Ultrasound
Yasunari Awa, MD, PhD; Kiyohito Takamatsu, MD, PhD; Akira Kawabata, MD
Yodogawa Christian Hospital, Osaka, Japan
Introduction: Some investigators have reported regarding the feasibility of investigating the location of perforators using preoperative color Doppler. The use of a dorsal metacarpal artery perforator (DMAP) flap is well known for treating skin defects of the dorsal hand and finger. Here we aimed to investigate the location of DMAP using color Doppler ultrasound (US).
Methods: We investigated DMAPs arising from the 2nd, 3rd, and 4th dorsal metacarpal arteries (DMAs) in 20 hands of healthy volunteers (10 women and 10 men) using color Doppler US (GE healthcare, Venue40).
Numbers and direction of perforators and their distance from the distal end of the metacarpal were evaluated.
Result: The total number of DMAPs was 88 (47 in men and 41 in women). The number of perforators arising from the 2nd, 3rd, and 4th DMAs was 31, 37, and 20, respectively. In six DMAs, no perforators were observed. The percentage of perforators directed to the dorsal, radial, and ulnar side were 72%, 19%, and 6%, respectively. Of all perforators, 61% were located within 25-mm proximal to the distal end of the metacarpal.
Discussion: Preoperative assessment of the location of DMAPs is very useful in designing a DMAP flap. Our results revealed that the number of perforators arising from the 2nd DMA was the highest, although substantial number of DMAPs was observed to be arising from 3rd and 4th DMA. Thus, it was possible to design flaps involving DMAPs from the 3rd and 4th DMA.
Moreover, investigating DMAPs using color Doppler US could be easy, safe, and useful.
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