[Foucher's first dorsal metacarpal artery island flap].
OBJECTIVE
Coverage of soft-tissue defects of the thumb, which cannot be covered primarily or with a skin graft, by a neurovascular pedicled island flap from the dorsum of the index finger.


METHODS
Combined skin and soft-tissue defects of the back of the hand, the thumb web space, and especially the thumb.


METHODS
Damages to the first dorsal metacarpal artery or the rete carpale dorsale. Previous injuries to the flap donor area. Local infection.


METHODS
Outlining of the skin flap design on the dorsum of the index finger. S-shaped skin incision at first web space radially. Identification of the first dorsal metacarpal artery and preparation of a fascioneurovascular pedicle for flap supply, with involvement of the fascia of the dorsal interosseous muscle in the flap pedicle. Intersection of the island flap from the index finger. Preparation and uplifting of the flap. Tunneling of the island flap under a skin bridge into the covering defect on the thumb. Fixation and suturing of the flap in the defect. Coverage of the flap defect on the dorsum of the index finger with a skin graft.


METHODS
Immobilization with a cast for 7 days, followed by finger mobilization and wound care.


RESULTS
During the years 2005 and 2006, 15 major soft-tissue defects of the thumb in eleven men and four women were reconstructed using a neurovascular island flap of the first dorsal metacarpal artery. The results were comparable to those previously reported in the literature. All flaps healed completely without any complications. The two-point discrimination measured an average of 8.8 mm.
Saalabian
Ali
A
Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt an der Saale, Germany. Asmd81@yahoo.de
Rab
Matthias
M
van Schoonhoven
Jörg
J
Prommersberger
Karl-Josef
KJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D003238:Connective Tissue / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005385:Fingers / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply*; D013933:Thumb / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult