The use of reverse-flow dorsal metacarpal artery flaps after postburn metacarpophalangeal joint flexion contracture release

Abstract

<jats:title>Abstract</jats:title><jats:p>When thermal injuries of the hand are managed inappropriately, complex hand contractures are inevitable. Patients with hand contractures may have many difficulties in their daily life because of this deformity. These patients are challenging to reconstructive surgeons. In this study we evaluated reverse-flow dorsal metacarpal artery flaps for the defects occurred after metacarpophalangeal joint contracture release of different fingers. Nineteen patients with defects on the volar surface of metacarpophalangeal joint were reconstructed by the reverse-flow dorsal metacarpal artery flaps. All operations were successful and flap losses were not seen. The DMCA flaps provide one stage coverage and permit primary closure of the recipient site. The aesthetic and functional results are satisfactory without sacrificing main arteries. The only drawback is the residual scar on the dorsum of the hand, which can be treated by conservative means and may improve over time.</jats:p>

Finger Reconstruction With Distally Based Dorsal Metacarpal Flaps

“…Although the arterial flow of DMAP flap is not reversed, that of RDMA and ERDMA flaps is retrograde flow from distal interconnections between the digital, palmar, and dorsal vascular network. Subsequently, the use of distally based dorsal metacarpal flaps increased with several modifications and was classified into 3 groups, each with its strengths and limitations: DMAP, RDMA, and ERDMA flaps 4–24 . Although soft tissue defects on fingers are frequently encountered in hand surgery, the reconstruction is challenging, and insufficient evidence is available in the literature on optimal flap selection because the characteristics and outcomes of each flap have only been previously described in separate studies for each flap.…”