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Is the Reversed Fourth Dorsal Metacarpal Flap Reliable?

From the Hand Unit Hospital Clinic, University of Barcelona and the Department of Anatomy, Autonomous University of Barcelona, Spain

Correspondence: J. R. Benito MD PhD, Department of Plastic Surgery, Hospital Clinic, C/ Villaroel, 170, 08036 Barcelona, Spain. E-mail: benito{at}medicina.ub.es

We have carried out a study to determine if a flap based on vessels in the fourth metacarpal space could be used safely. We studied ten fresh cadaver specimens and used the flap in nine patients. In the anatomical study, we confirmed the presence of a suitable artery in nine out of the ten hands, arising from a piercing artery at the metacarpal bases, running distally under the fascia. The pivot point is located at the metacarpal heads, where the artery anastomoses to palmar branches and dorsal digital branches. In the clinical setting, the flap was reliable in eight patients. There was one case of flap necrosis. The flap seems to be reliable but several technical points are stressed to avoid complications.

Journal of Hand Surgery (British and European Volume), Vol. 25, No. 2, 135-139 (2000)
DOI: 10.1054/jhsb.1999.0333


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