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

Kim, Jeeyoon; Seo, Bommie Florence; Lee, Jun-Ho; Jung, Sung No

doi:10.1055/a-1938-1072

Cited by 2 publications

(2 citation statements)

References 11 publications

(28 reference statements)

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“…In pediatric age, the superficial circumflex radial artery and anterolateral thigh flap would not have provided the thin and glabrous skin to subcutaneous fat thickness. The First Dorsal Metacarpal Artery (FDMA) flap is also used in the reconstruction of this region, but we were skeptical of the flap's reliability due to both the size of the area and the electrical burn (Kim et al, 2022). Other alternatives include the superficial palmar branch of the radial artery (SPBRA) flap and the dorsoulnar artery perforator (DUAP) flap with short pedicles that may not provide the required long pedicle.…”

Section: Discussionmentioning

confidence: 99%

“…However, distal volar and dorsal defects cannot be reconstructed with an extended dorsal metacarpal flap (Coombs & Mutimer, 1994). This case presents the first case in which volar finger contracture reconstruction was performed with an expanded first DMCAP flap The First Dorsal Metacarpal Artery (FDMA) flap is also used in the reconstruction of this region, but we were skeptical of the flap's reliability due to both the size of the area and the electrical burn (Kim et al, 2022). Other alternatives include the superficial palmar branch of the radial artery (SPBRA) flap and the dorsoulnar artery perforator (DUAP) flap with short pedicles that may not provide the required long pedicle.…”

Section: Morgan Et Al Published Their Article In 1985 In Which They P...mentioning

confidence: 99%

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Reconstruction of finger contracture with an expanded first dorsal metacarpal artery perforator flap: A case report

et al. 2023

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Volar finger contractures can be challenging for plastic surgeons. The dorsal metacarpal artery perforator (DMCAP) flap is frequently used to cover bones, tendons, and neurovascular structures in the dorsum of the hand after trauma and burns as an alternative to grafts and free flaps. We aimed to report volar finger defect reconstruction with expanded DMCAP flap. A 9‐year‐old male patient applied to our clinic with the complaint of inability to open the second finger of the left hand after an electrical burn that caused proximal and distal interphalangeal joints flexion contractures. Reconstruction was planned for the patient with a two‐session expanded first DMCAP flap. A 16 mL 5 × 3 cm tissue expander was placed in the prepared area from the vertical incision in the first session. The tissue expander was inflated with 4 mL of isotonic solution. The DMCA area was enlarged 6 weeks later by giving 22 mL of isotonic solution. After the pedicle dissection, the 9 × 3 cm DMCAP flap was elevated by dissection over the paratenon. With 180° of rotation, the left‐hand second finger was adapted to the 6 × 2 cm defect area on the volar face. The flap donor site was closed primarily. The operation was terminated by placing the hand on a protective splint. There were no complications in the flap in the postoperative 6 months. The patient was referred to the physical therapy and rehabilitation department. As a result, an expanded DMCAP flap may cover volar tissue defects up to the distal phalanx. This report may present the first case in which volar finger contracture reconstruction was performed with an expanded first DMCAP flap after an electrical burn in a pediatric patient.

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Section: Discussionmentioning

confidence: 99%

Section: Morgan Et Al Published Their Article In 1985 In Which They P...mentioning

confidence: 99%

Reconstruction of finger contracture with an expanded first dorsal metacarpal artery perforator flap: A case report

et al. 2023

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The Small Finger Reverse Ulnar Digital Artery Hypothenar Palmar Perforator Flap: An Anatomical Study With Clinical Examples

Kunda,

Cai,

Dagum

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Local flaps are commonly used for reconstruction of digital soft-tissue defects. There remains a paucity of options available for small finger volar and dorsal soft-tissue defects distal to the proximal interphalangeal joint. The purpose of this study was to analyze perforators along the hypothenar palmar region arising from the artery of the ulnar side of the small finger as it comes off the superficial palmar arch for consistency and potential to be used for perforator-based flap reconstruction of soft-tissue defects and joint coverage of the small finger. Methods: Four cadaveric upper extremities were injected with Microfil silicone injection compound. Dissection was performed from the superficial palmar arch to the ulnar digital artery of the small finger, and perforators were identified and analyzed for consistency and utility. Flap elevation was performed based on these perforators in a small finger reverse ulnar digital artery fashion. Results: All cadaveric dissections showed a suitable perforator pattern along the hypothenar palmar region with a minimum of 5 perforators available from which to base a flap to address dorsal and volar defects of the small finger. Two clinical examples are presented confirming the viability and utility of this flap. Conclusions: A detailed anatomic study with 2 clinical examples of this retrograde pedicle island flap is presented. The small finger reverse ulnar digital artery hypothenar palmar–based perforator flaps are a viable option with a reliable perforator pattern, providing a functional solution for reconstruction of soft-tissue defects and joint coverage of the small finger.

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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

Cited by 2 publications

References 11 publications

Reconstruction of finger contracture with an expanded first dorsal metacarpal artery perforator flap: A case report

Reconstruction of finger contracture with an expanded first dorsal metacarpal artery perforator flap: A case report

The Small Finger Reverse Ulnar Digital Artery Hypothenar Palmar Perforator Flap: An Anatomical Study With Clinical Examples

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