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Subject Area

Plastic Surgery

Article Type

Original Study

Abstract

Objectives To assess the outcome of the extended dorsal metacarpal artery (DMCA) flap and its modifications for coverage of finger defects distal to the proximal interphalangeal (PIP) joint. Background The extended DMCA flap is a reliable solution for resurfacing soft-tissue defects in hand surgery. However, limited studies have used it to reconstruct defects beyond the PIP joint. This study reports a novel experience applying this flap for various finger defects distal to the PIP joint. Patients and methods This study was conducted on 21 patients who underwent an extended DMCA flap transfer. Flap length was measured from the pivot point (midpoint of the proximal phalanx) to the distal border of the extensor retinaculum. The donor length was traced to the recipient-site fingers to determine the coverage area. All patients with single or multiple finger defects over volar/dorsal surface up to the Distal interphalangeal joint (DIP) joint were included. Patients with associated injury in the skin of the dorsum of the hand and thumb defects were excluded. Results All flaps survived, and the average flap size was 9.31 ± 3.49 cm2 (range, 4.5–15 cm2). All donor sites were primarily closed, and skin grafting was not needed to close the donor defect. Complications recorded were venous congestion in six flaps, and no arterial insufficiency was recorded. Conclusions The extended DMCA flap is a simple and pliable flap with minimal donor-site morbidity and can be used to cover soft-tissue defects up to the DIP joint.

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