Reverse dorsoradial metacarpal artery flap for reconstruction of large finger skin defect: A case report

Introduction and importance: Plastic reconstructive surgery for defects of hand still pose a challenge to plastic surgeons. The skin envelope of the hand is a complex structure that not only covers the underlying tissues but also includes particular functional and sensory components. The main principle of therapy is to provide adequate and long-lasting coverage to minimize surgery scars.Case presentation: A 63 years old man was referred to our hospital from another facility with a soft tissue defect on his right index finger at the level of the interphalangeal joint. The injury occurred 4 hours prior when he was injured by a sickle while working in a rice field. The defect was measured 2 x 4 cm and the base was visible, exposing the underlying fascia with minimal contamination. The patient underwent treatment with a reverse dorsoradial metacarpal artery flap, which was elevated from the thumb. After one month, he returned to the hospital with complains of pain and drainage from the donor site over the past few days. Debridement was performed and the area was repaired with local anesthesia. Patient didn't complains about the functional impairment.Clinical discussion: Compound defects of the hand need urgent surgical intervention and flap covering to prevent stiffness, improve the range of motion and facilitate early return to work. The reverse dorsoradial metacarpal artery flap is an excellent option for finger defects reconstruction. Conclusion: This study showed that the reverse dorsoradial metacarpal artery flap is a viable flap for reconstructing finger defects.