[The third dorsal metacarpal artery neuromuscular island flap]

This paper describes the usefulness of the third dorsal metacarpal artery neurovascular island flap in the repair of soft tissue defect of the hand. The flap is based on the third dorsal metacarpal artery as its vascular pedicle, and it has been successfully used in 12 cases since 1990. We found the third dorsal metacarpal artery was larger and more constant than the first, and so the blood supply was highly guaranteed. There were no failures or donor site complications. However, the flap has its limitation. It is only suitable for covering relatively small defects. The anatomy and clinical dissection of the flap are described.