Clinical anatomy of the dorsal venous network in fingers with regard to replantation.

The arterial system of fingers is anatomically well described, and so, usually no difficulties arise during its preparation and the making of anastomoses in replantation surgery. Difficulties may occur, however, during manipulation in the dorsal vascular bed of fingers, known only as a random venous network. There are minimal references to its existence and the location of its valvular apparatus. Using a microscopic preparation, a contrast staining, and a histological assessment, topographic relations and the course of veins of the dorsal venous network, as well as the existence and location of their valvular apparatus, was investigated on 72 three-phalanx fingers. The specimens were either harvested from fresh cadavers or traumatically amputated. We found that veins of rather significant caliber predominantly run along the dorsal aspect of the finger on both the radial and ulnar sides above the proximal phalanx of three-phalanx fingers. Proximally, venous systems of respective neighboring fingers connect in the interdigital space. The valvular apparatus was found at all levels ranging from metacarpophalangeal joints to the distal phalanx. The valves were always located distally from the confluence of two veins. Aside from this confluence, the existence of valves was not observed. The exact description of architecture of this venous system, in practice, contributes to faster orientation, better preparation, and the creation of safer anastomoses of these structures, and thus, to an increased success of replantation.