title: Direct and reversed dorsal digito-metacarpal flaps: a review of 24 cases.
abstract: OBJECTIVE
  The common source for reconstruction of soft tissue defects of the fingers is either the same finger or the adjacent finger. However, when the donor areas are damaged by concomitant injuries, these options are not available. The purpose of this study was to report on reconstruction of these complex digital injuries using the dorsal digito-metacarpal flaps (DDMFs) and to evaluate the efficacy of this technique.
  
  
  METHODS
  A retrospective study was conducted with 24 patients who had their fingers reconstructed using the DDMF from April 2009 to September 2011. The patients were divided into two groups based on the flow direction of the blood supply. Among them, nine patients had their fingers reconstructed with the direct DDMFs. Fifteen patients underwent tissue reconstruction in the distal phalanx with the reversed DDMFs.
  
  
  RESULTS
  At a mean follow-up of 20 months (range, 18-24 months), the mean static two-point discrimination on the flaps was 8.3 mm (range, 7-10 mm) in the direct DDMF group and 10.4 mm (range, 9-14 mm) in the reversed DDMF group, with a significant difference (P=0.001). The range of motion of the donor fingers was similar to that of the opposite hands. According to the Michigan Hand Outcomes Questionnaire, 11 patients were very satisfied, 10 were satisfied and three were neither satisfied nor dissatisfied with functional recovery of the reconstructed finger.
  
  
  CONCLUSIONS
  The DDMF is an additional option for coverage of a soft tissue defect of the finger when the commonly used local and regional flaps are not feasible.
  
  
  BACKGROUND
  NCT 01927003.
  
  
  METHODS
  Therapeutic/IV.
authors: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China.
authors: Chao
authors: C
authors: Chen
authors: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, Hebei 063000, PR China; Affiliated Hospital of North China Coal Medical College (Hebei United University), Tangshan, Hebei 063000, PR China.
authors: Wenlong
authors: W
authors: Zhang
authors: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China. Electronic address: tangpeifubeijing@163.com.
authors: Peifu
authors: P
authors: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology* / Q000601:surgery*; D005385:Fingers / Q000098:blood supply* / Q000294:innervation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation*; D016896:Treatment Outcome
keywords: Defect; Dorsal branch of the digital artery; Dorsal digital flap; Dorsal metacarpal artery flap