超音波カラードプラを用いた第2背側中手動脈皮弁穿通枝の検索

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  • Color Doppler Ultrasound Assessment to Identify the Perforator Artery of the Second Dorsal Metacarpal Flap

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The second dorsal metacarpal (SDMC) flap has been used for soft tissue reconstruction of the dorsal side of the hand. However, it is difficult to identify the depth, path, and branches of the second dorsal metacarpal artery (SDMA) perforators only using an ultrasound Doppler stethoscope. The purpose of this study was to evaluate the efficacy of color Doppler ultrasonography to detect the perforators to help design the SDMC flap. Twenty healthy volunteers (forty hands) were examined using color Doppler ultrasonography and an ultrasound Doppler stethoscope. The SDMA and its perforators were mapped at all points where the perforators seemed to penetrate through the fascia of the interosseous muscle. The average number of SDMA perforators was found to be 2.7 branches per hand using color Doppler ultrasonography, while it was 1.8 branches per hand using the ultrasound Doppler stethoscope. The perforators were found in all cases by the color Doppler ultrasonography. Most perforators were found to be around the distal 1/4 and proximal 1/3 of the second metacarpal. It is concluded that color Doppler ultrasonography can identify perforators and help in making the assessment of vascularity for an SDMC flap.

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