The reverse dorsal metacarpal artery flap in finger reconstruction: A reliable choice

The finger skin and soft-tissue defects are reconstructive challenges due to their nature and the intricate extensor apparatus and flexors it protects. The reverse dorsal metacarpal artery (RDMA) is a time-tested option for the reconstruction of the same.

A total of 14 cases of RDMA flap for finger defects involving proximal to distal phalanx were performed. Thirteen of these patients were male and one patient female and the most common mode of injury was occupational in nature followed by road traffic accident. The overall appearance was assessed for the flap and the donor site. The associated injuries and the range of motion were noted.

All but one flap survived completely. One patient had partial distal flap loss, which was tackled with split-thickness skin grafting. The flap size varied from 3.5 cm × 1.5 cm to 9 cm × 2 cm with mean of 6.64 cm × 1.72 cm. The mean age of the patients was 33.4 years. All the patients had acceptable aesthesis. The donor site had no complications and healed with linear scar.

RDMA flap is a reliable flap for finger defects reconstruction. The range of movement mainly depends on the associated injury rather than flap transfer alone and to prove this we require doing analysis of range of movement in patients with flap done alone or with associated injuries.