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The Heart (HT)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Common palmar digital artery for 4th and 5th digits: Each common palmar digital artery divides into proper palmar digital arteries, which give rise to a dorsal branch innervating the finger tips with vessels known as the dorsal branches of the proper palmar digital arteries. The proper palmar digital arteries course along the adjacent sides of digits II through IV.
Treatment of cold intolerance following finger pulp amputations: a case comparison between immediate finger replantation and delayed pulp and digital arterial arch reconstruction with flow-through free hypothenar flap
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Ryohei Ishiura, Makoto Shiraishi, Yoshimoto Okada, Kohei Mitsui, Chihena Hansini Banda, Kanako Danno, Mitsunaga Narushima
Preoperatively, locations of the hypothenar perforators were identified by color doppler ultrasound (APLIO 500 TUS − A500, Toshiba, Japan) and marked. Reconstruction was performed under general anesthesia and hemorrhage controlled with a pneumatic tourniquet. A 40 × 15 mm hypothenar perforator flap was designed in the ipsilateral hand and incised from the ulnar side. The flap was elevated above the palmaris brevis fascia with two artery perforators and two cutaneous veins included in the flap. The perforators were then dissected proximally and the pedicles prepared. The diameter of the artery pedicle was 1 mm on the proximal side and 1 mm on the distal side. A pedicle length of 15 mm was included in the flap for reconstruction of the digital arterial arch. The middle finger was prepared for the transfer with bilateral mid-lateral incisions and excision of the scar tissue. Bilateral proper palmar digital arteries and palmar digital veins were prepared for the anastomoses. The diameters of the recipient arteries were 1 mm on the ulnar side and 0.9 mm on the radial side. The diameters of the recipient’s veins were 1.2 mm on the ulnar side and 1 mm on the radial side. The harvested flap was placed on the prepared site with the distal side of the flap on the ulnar side of the fingertip. Both arteries were anastomosed in end-to-end fashion in flow-through style and both veins were also anastomosed end-to-end in antegrade fashion (Figure 2). The donor site was closed primarily. Intravenous Prostaglandin E1 analog (Apistandin, Fuji Pharma Co., Ltd, Tokyo, Japan) was administered at 40 micrograms a day for a week.