Versatility of Dorsal Metacarpal Artery Flaps (DMAFs) for coverage of hand defects.
Background: Hand defects coverage could represent a challenge for hand surgeons. The dorsal metacarpal artery flap (DMAF) might be considered as good choice in small to medium size defects. It can be designed as antegrade, reversed, composite or adipofascial. The aim of our study was to re-visit and re-evaluate the versatility of the DMAFs flaps for reconstruction of hand defects of different causes and in different ages. Methods: We present a series of 23 cases of hand defects with different etiologies. Their age ranged between 1 to 59 years old. Mean age was 18.82 years. Causes were; Post-traumatic in 8 patients (34.78%), Post-burn in 8 patients (34.78%), Post-excision in 1 patient (4.35%) and Congenital in 6 patients (26.1%). Flap selection has been individualized according to the location and the size of the defect. Flap reach, survival and sensation were evaluated. Results: 23 patients had hand defects of different causes. Flaps fully survived in 19 patients (86.96%), partially lost in three flaps (8.69%) and completely lost in one flap (4.35%). First and second ante-grade dorsal metacarpal flaps were sensate, however cortical reorientation was not achieved in any flaps. Conclusion: DMAFs are versatile flaps in reconstruction of different types of soft tissue hand defects. DMAFs can cover dorsal and volar aspects of fingers, web spaces defects and considerable medium size defects of hand dorsum. It can be used as immediate management in selected cases of hand trauma.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.