The first dorsal metacarpal propeller perforator (FDMP) flap for finger reconstruction

Summa, Pietro G. di; Davies, Kerry J.; Hart, Andrew

doi:10.1080/23320885.2020.1806069

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…3,4,10,11,14,15 There has been a recent report on flaps elevated based on perforators from the first dorsal metacarpal artery for finger defects also and reverse first dorsal metacarpal artery flaps. 19,24 We have no experience with these flaps.…”

Section: Discussionmentioning

confidence: 99%

Applications and Reliability of Dorsal Metacarpal Artery Perforator Flap

Jayachandiran,

Rajendran,

Mahipathy

et al. 2023

Indian J Plast Surg

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Dorsal metacarpal artery perforator flap, first described by Quaba and Davison, is a useful tool in the armamentarium of plastic surgeons. It provides like for like tissue for the reconstruction of dorsal finger defects. It is a simple and relatively easy flap to harvest with minimal donor site morbidity. In this case series, we present our experience, applications, and surgical technique of flap harvesting.

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Section: Discussionmentioning

confidence: 99%

Applications and Reliability of Dorsal Metacarpal Artery Perforator Flap

Jayachandiran,

Rajendran,

Mahipathy

et al. 2023

Indian J Plast Surg

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“…introduced the first web space defect as a propeller flap using an FDMA perforator [8]. However, it does not reach the PIPJ or more distal defect since its flap length was too short.…”

Section: Discussionmentioning

confidence: 99%

“…di Summa et al introduced the first web space defect as a propeller flap using an FDMA perforator. 8 However, it does not reach the PIPJ or more distal defect since its flap length was too short. Aizawa et al conducted a study to find the FDMA perforator in 29 cadavers.…”

Section: Discussionmentioning

confidence: 99%

“…Through this method, it is possible to reach the PIPJ defect that is far from the FDMA perforator of the metacarpal neck area compared with the previously introduced FDMA perforator flaps. 8 9 Venous congestion was prevented through elevation of the fascia. By choosing the perforator at the metacarpal neck area rather than the proximal phalanx level, the arterial supply is also more stable, and the flap is easier to elevate and has fewer complications.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, unlike the aforementioned reverse DMCA flap, the oblique extended reverse FDMA perforator flap is elevated oblique proximally, and the flap spans the 2 nd to 4 th metacarpal bone. Through this method, it is possible to reach the PIPJ defect that is far from the FDMA perforator of the metacarpal neck area compared to the previously introduced FDMA perforator flaps [8,9]. Venous congestion was prevented through elevation of the fascia.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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The Oblique Extended Reverse First Dorsal Metacarpal Artery Perforator Flap for Coverage of the Radial-Volar Defect of the Proximal Interphalangeal Joint in the Index Finger: A Case Report

et al. 2022

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The dorsal metacarpal artery perforator flap is a flap that rises from the hand dorsum. Owing to its reliability and versatility, this flap is used as a work-horse for finger defect. However, to cover the radial-volar defect of the proximal interphalangeal joint (PIPJ) of the index finger, a longer flap is required than before. Here, we introduce the oblique extended reverse first dorsal metacarpal artery (FDMA) perforator flap to cover the radial-volar aspect defect of the index finger. A 45-year-old male got injured to the radial-volar defect of PIPJ of the left index finger caused by thermal press machine. The wound was 2x1cm in size and the joint and bone were exposed. We used FDMA perforator from anastomosis with palmar metacarpal artery at metacarpal neck. Since the defect was extended to the volar side, the flap was elevated by oblique extension to the fourth metacarpal base level. The fascia was included to flap, and the flap was rotated counterclockwise. Finally PIPJ was fully covered by the flap. Donor site was primarily closed. After 12 months of operation, flap was stable without complication and limitation of range of motion The oblique extended reverse FDMA perforator flap is a reliable method for covering the radial-volar defect of the PIPJ of the index finger. This flap, which also has an aesthetic advantage, will be a good choice for hand surgeons who want to cover the PIPJ defect of the index finger using a non-microsurgical option.

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First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

et al. 2021

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Background Many approaches have been reported to repair soft-tissue defects of the hand using dorsal metacarpal artery flaps. Use of a perforator-based propeller flap from the first intermetacarpal space to the dorsum of the hand has been described. The aim of this study was to confirm the functional anatomy of a first dorsal metacarpal artery (FDMA) perforator flap. Methods Twenty-nine fixed cadaveric hands were dissected to determine the origin, course, and branches of the FDMA. Clinically, five cases of soft tissue defects of the hand underwent reconstructive surgery using an FDMA perforator-based propeller flap. ResultsThe FDMA was found in 27 specimens (93%). The ulnar branch of the FDMA always supplied the cutaneous perforator (mean ± SD, 4.3 ± 1.6), and the most distal cutaneous perforating branch was found along the metacarpal long axis within 25 mm of the tip of the metacarpal head with high frequency (28/29, 97%). In the two hands that had aplasia of the FDMA, well-developed perforators arose directly from the radial artery and advanced to the metacarpal head. Seven hands (24%) had perforators arising from the palmar arterial system, penetrating through or passing close by the second metacarpal bone. In clinical application, all the flaps survived completely without major complications. Conclusions The FDMA perforator-based propeller flap is minimally invasive and technically simple. It is expected to be a new option for hand reconstruction.

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The first dorsal metacarpal propeller perforator (FDMP) flap for finger reconstruction

Cited by 4 publications

References 13 publications

Applications and Reliability of Dorsal Metacarpal Artery Perforator Flap

Applications and Reliability of Dorsal Metacarpal Artery Perforator Flap

The Oblique Extended Reverse First Dorsal Metacarpal Artery Perforator Flap for Coverage of the Radial-Volar Defect of the Proximal Interphalangeal Joint in the Index Finger: A Case Report

First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

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