The dorsal digital arteries arise from the dorsal metacarpal arteries (from the dorsal carpal arch) and supply the dorsal skin of the fingers from the MCP joint to the level of the PIP joint. They are smaller than the palmar digital arteries and anastomose with them at the PIP joint level. The nail bed and pulp are supplied predominantly by the palmar digital arteries.
The dorsal digital arteries are the basis of dorsal digital island flaps used for fingertip reconstruction and nail bed coverage. Dorsal finger flaps rotated on the dorsal digital artery provide thin skin for palmar defects. In replantation surgery, dorsal digital vein repair is performed first to restore venous drainage, followed by palmar digital artery anastomosis. The dorsal digital arteries are at risk in dorsal finger surgery and in dermofasciectomy for Dupuytren disease.
A dorsal digital island flap elevated on the dorsal digital artery and subcutaneous pedicle from the middle or proximal phalanx dorsum provides thin glabrous-approximating skin for fingertip pulp defects without sacrificing the palmar digital artery; the flap rotates 90-180 degrees on its vascular pedicle.
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