Finger Reconstruction With Distally Based Dorsal Metacarpal Flaps

Abstract

BackgroundDistally based dorsal metacarpal flaps for the reconstruction of finger soft-tissue defects are classified into 3 categories: dorsal metacarpal artery perforator flap, reverse dorsal metacarpal artery (RDMA) flap, and extended reverse dorsal metacarpal artery (ERDMA) flap. The present systematic review aimed to evaluate differences in the outcomes of commonly encountered defects and postoperative complications among these three flaps.MethodsPubMed, Scopus, and Web of Science were systematically searched from when the flats were first reported to May 2021. Random-effects meta-analysis for each outcome was performed, and 24 studies were included in the analysis.ResultsDorsal metacarpal artery perforator flaps were mainly used for defects extending to the proximal interphalangeal joint (n = 62 [29.1%]) and proximal phalanx (n = 85 [39.9%]). Conversely, defects extending to the distal phalanx (n = 24 [43.6%]) were mostly reconstructed using the ERDMA flap. The rate of venous congestion was highest for the ERDMA flap (29.3%; 95% confidence interval [CI], −17.2% to 65.1%; I2 = 0%) and lowest for RDMA flap (8.1%; 95% CI, −5.9% to 21.7%; I2 = 0%). The RDMA flap showed the lowest rate of any short-term complications, including partial and total necrosis (6.6%; 95% CI, −6.8% to 19.8%; I2 = 0%).ConclusionsThis systematic review demonstrated that the dorsal metacarpal artery perforator flap was suitable for reconstruction proximal to the middle phalanx, and the ERDMA flap was suitable for reconstruction distal to the distal interphalangeal joint. Although the RDMA flap showed the lowest rate of short-term complications and limited analysis was secondary to limited data available, these occurred in 6.6% to 10.9% of distally based dorsal metacarpal flaps.

Digital Artery Perforator Flap for Fingers Reconstruction: A Meta-Analysis Study with Clinical Cases

“…In this respect, Shimbo et al [39] reported that the dorsal metacarpal artery perforator flaps were versatile options for covering proximal to the middle phalanx and distal to the distal interphalangeal joint. This was associated with a lower rate of short-term consequences.…”

Fetal Anatomy of the Arteries of the Dorsum of the Hand

“…Фетальні оперативні втручання в ділянці кисті, як ніякі інші операції, вимагають докладного топографоанатомічного обґрунтування і всебічних даних з варіантної анатомії артеріальних судин кисті [10][11][12], зокрема тильної поверхні, впродовж плодового періоду онтогенезу людини. Тому, відомості стосовно вікової та індивідуальної анатомічної мінливості артеріальних судин тильної ділянки кисті у плодів людини мають важливе науково-практичне значення для тлумачення істинного напрямку процесів фетального морфогенезу кисті за умов норми.…”