[Repair of soft tissue defects of wrist and fingers by antegrade and retrograde dorsal metacarpal flaps with cutaneous branches as pedicles].
OBJECTIVE
To investigate the procedure and applications of antegrade and retrograde dorsal metacarpal flaps with cutaneous branches as pedicles in repairing soft tissue defects of wrist and fingers.


METHODS
From 1995 to 2003, we observed that the proximal and distal branches, deriving from the dorsal metacarpal artery, formed a consistent anastomosis arc subdermally. The anastomosis arc was paralleled to the dorsal metacarpal artery. Antegrade and retrograde dorsal metacarpal flaps could be designed using proximal and distal branches as pedicles. Twenty-seven cases of soft tissue defects were treated by use of dorsal metacarpal flaps with cutaneous branches as pedicles, including 3 cases of defects on dorsum of hand with antegrade flaps, and 24 cases of defects on fingers with retrograde flaps (index finger: 12 cases; middle finger: 6 cases; ring finger: 4 cases; and little finger: 2 cases). The dimensions of the antegrade flaps were 2.0 cm x 4.0 cm - 4.0 cm x 6.0 cm, and the dimensions of the retrograde flaps were 2.5 cm x 3.5 cm - 3.0 cm x 7.0 cm. The incision of the donor site was closed directly.


RESULTS
All flaps survived. After a follow-up of 1-3 years, the texture and color of the flaps were good, and the shape and function of the donors were normal.


CONCLUSIONS
The antegrade or retrograde flap pedicled with the distal or proximal cutaneous branches of the dorsal metacarpal artery, is an optimal flap in repairing finger or wrist soft tissue defects.
Lu
Laijin
L
Department of Hand Surgery, the First Clinical College Affiliated to Jilin University, Changchun Jilin, 130021, PR China.
Gong
Xu
X
Liu
Zhigang
Z
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D002648:Child; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D014953:Wrist / Q000098:blood supply / Q000601:surgery; D014954:Wrist Injuries / Q000601:surgery*