Reverse-flow first dorsal metacarpal artery flap for index fingertip reconstruction

Dorsum of the hand is an ideal skin-flap donor site for coverage of hand or finger defects. We elevated 8 reverse-flow first dorsal metacarpal artery flap in 9 patients for soft-tissue cover of index fingertip injuries distal to distal interphalangeal joint with exposed bone. In 3 patients, the digital branch of the superficial radial nerve was coapted to the digital nerve. All flaps healed uneventfully, except for 1 patient in which partial necrosis of the flap occurred. Postoperative follow-up was 4-12 months (mean, 8 months). Reverse-flow first dorsal metacarpal artery flap is a good alternative for reconstruction of index fingertip injuries.