Free vascularized metacarpal bone graft combined with extended dorsal metacarpal artery flap for phalangeal bone and soft tissue loss: case report

Saalabian, Ali; Unglaub, Frank; Horch, Raymund E.; Kneser, Ulrich

doi:10.1007/s00402-011-1378-2

Cited by 13 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 22 ] Vascularised bone transfer is also possible along with the DMA flap from the corresponding metacarpal bone, more with the 2 nd DMA flap. [ 23 24 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

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

Balan¹,

Mathew²,

Kumar³

et al. 2018

Indian J Plast Surg

View full text Add to dashboard Cite

Background: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.Materials and Methods: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.Results: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.Conclusions: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.

show abstract

“…[ 22 ] Vascularised bone transfer is also possible along with the DMA flap from the corresponding metacarpal bone, more with the 2 nd DMA flap. [ 23 24 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

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

Balan¹,

Mathew²,

Kumar³

et al. 2018

Indian J Plast Surg

View full text Add to dashboard Cite

show abstract

“…These distally based reverse cutaneous island flaps were popularized by Maruyama and Quaba: Maruyama described a reverse DMCA flap with skin paddle harvest directly over the pedicle, while Quaba based an axial pattern flap on perforators from the DMCA. These flaps can reach the distal phalanx, with Jing et al suggesting the arc of rotation of a flap based on the SDMA, either anterograde or retrograde, can reach the fingertips, spanning the width of the hand dorsally, a finding confirmed by Ardouin et al…”

Section: Discussionmentioning

confidence: 79%

“…Homodigital middle to distal phalanx vascularized bone transfer has also been described . Alternatively, free vascularized bone grafts for distal digit reconstruction have been performed, with hemi‐metatarsal, partial toe, hemi‐hamate, and second metacarpal based on anterograde SDMA flow all described …”

mentioning

confidence: 99%

Reverse second dorsal metacarpal artery vascularized bone flap for index distal bone loss: A case report

2015

View full text Add to dashboard Cite

Fingertip trauma with resultant bony loss is optimally reconstructed with an autologous bone substitute, offering a unique opportunity for use of a local vascularized bone graft. The second dorsal metacarpal artery is well-described for use in soft tissue and bony reconstruction, with recent cadaveric studies suggesting a reverse-flow second dorsal metacarpal artery bone flap could reach defects in the distal phalanx. The aim of the current report is to illustrate the use of this technique in reconstructing the distal digit in a traumatized index finger with bony loss of the middle third of the distal phalanx. A 49-year-old man presented with a traumatic circular saw injury to his left index finger, with the unique finding of distal phalanx bony loss to the middle third of this bone, with no associated disruption of palmar or dorsal structures. Reconstructive goals were solely that of bony reconstruction, with no soft tissue coverage required. A reverse SDMA vascularized bone flap was successfully used for reconstruction, with the vascularized bone flap mobilized on its reverse SDMA pedicle and pivoted at the level of the distal anastomoses between the palmar and dorsal metacarpal arteries. There was uncomplicated donor and recipient site closures, and good functional outcomes with the ability to retain full distal interphalangeal joint motion and force on distal pinch grip. This case shows that the reverse second dorsal metacarpal artery vascularized bone flap may be undertaken to reconstruct bony loss in the distal phalanx.

show abstract

“…11 For reconstruction of both skin and bone at the distal interphalangeal (DIP) joint level, there is no report of reconstruction in such cases with the pedicled compound flap using DMA. [12][13][14] Herein, we report the surgical procedure and clinical outcomes of a patient with skin, nerve, and joint defects at the DIP joint who underwent a pedicled chimeric flap reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Yano¹,

Kaneshiro²,

Ishiko³

et al. 2023

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

The reconstruction for mild tissue loss at the distal part of a finger is challenging. We report about a 29-year-old man presenting with traumatic tissue loss at the distal interphalangeal (DIP) joint of the index finger, including skin, bone, and nerve. Reconstruction using two types of flaps was performed. The dorsal skin flap, nourished by the second dorsal metacarpal artery (SDMA) perforator, was elevated. The vascularized second metacarpal bone, nourished by the SDMA, was also elevated. Using the vascular connection between the DMA and the palmar digital artery (PDA), both flaps were raised to the distal part of the finger, and the pivot point was set at the dorsal proximal phalanx. After arthrodesis of the DIP joint with the vascularized second metacarpal bone, the digital nerve was repaired using the cutaneous nerve in the skin flap, and the skin defect was covered using the perforator flap. The postoperative course, including flap survival and bone union, was uneventful. A good indication for the reconstruction of the distal part of a finger with this technique is when the defect sizes of the skin and bone differ and the vascular connection between the SDMA and dorsal branch of PDA is not injured.

show abstract

Free vascularized metacarpal bone graft combined with extended dorsal metacarpal artery flap for phalangeal bone and soft tissue loss: case report

Cited by 13 publications

References 16 publications

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

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

Reverse second dorsal metacarpal artery vascularized bone flap for index distal bone loss: A case report

Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

Contact Info

Product

Resources

About