Reverse dorsal metacarpal artery flap to cover skin and soft tissue defects over fingers proximal to distal interphalangeal joint

Background: Finger injuries with soft-tissue loss and exposure of tendons, joints, or bones require stable and durable vascularized flap coverage to preserve hand function. The aim of the study was to evaluate the clinical outcomes of reverse dorsal metacarpal artery flap reconstruction for covering skin and soft-tissue defects of the fingers proximal to the distal interphalangeal joint. Methods: This descriptive observational study was conducted at the Department of Plastic Surgery and 100-Bed Burn Unit, Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh, from February 2016 to January 2017. 50 (fifty) patients were included with finger skin and soft-tissue defects proximal to the distal interphalangeal joints. Reconstruction was done by Reverse dorsal metacarpal artery flap. Flap survival, donor-site morbidity, and joint function were assessed. Data were analyzed using SPSS after obtaining informed consent. Results: Among 50 patients, most were male (42, 84.0%) and aged 25-35 years (27, 54.0%). Index-finger defects (24, 48.0%) and electric burns (31, 62.0%) predominated. Complete flap survival occurred in 39 patients (78.0%), with no donor-site morbidity in 43 (86.0%). Full MCP and PIP movement was achieved in 39 (78.0%) and 45 (90.0%) patients, respectively. Conclusions: The reverse dorsal metacarpal artery flap is a simple, reliable, single-stage option for skin and soft-tissue reconstruction of fingers proximal to the distal interphalangeal joint, with minimal donor-site morbidity and early functional recovery.