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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(06): 760-763
DOI: 10.1055/a-1938-1072
Hand/Peripheral Nerve
Case Report

The Oblique Extended Reverse First Dorsal Metacarpal Artery Perforator Flap for Coverage of the Radial-Volar Defect of the Proximal Interphalangeal Joint in the Index Finger: A Case Report

Jeeyoon Kim
1   Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Republic of Korea
,
Bommie Florence Seo 
1   Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Republic of Korea
,
Junho Lee
1   Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Republic of Korea
,
Sung No Jung 
1   Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Republic of Korea
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Abstract

The dorsal metacarpal artery perforator flap is a flap that rises from the hand dorsum. Owing to its reliability and versatility, this flap is used as a workhorse for finger defect. However, to cover the radial-volar defect of the proximal interphalangeal joint (PIPJ) of the index finger, a longer flap is required than before. Here, we introduce the oblique extended reverse first dorsal metacarpal artery (FDMA) perforator flap to cover the radial-volar aspect defect of the index finger. A 45-year-old man got injured to the radial-volar defect of PIPJ of the left index finger caused by thermal press machine. The wound was 2 × 1 cm in size, and the joint and bone were exposed. We used FDMA perforator from anastomosis with palmar metacarpal artery at metacarpal neck. Since the defect was extended to the volar side, the flap was elevated by oblique extension to the fourth metacarpal base level. The fascia was included to the flap, and the flap was rotated counterclockwise. Finally, PIPJ was fully covered by the flap. Donor site was primarily closed. After 12 months of operation, the flap was stable without complication and limitation of range of motion. The oblique extended reverse FDMA perforator flap is a reliable method for covering the radial-volar defect of the PIPJ of the index finger. This flap, which also has an aesthetic advantage, will be a good choice for hand surgeons who want to cover the PIPJ defect of the index finger using a nonmicrosurgical option.

Keywords

finger injuries - perforator flap - hand injuries

Patient Consent

The patient provided written informed consent for the publication and the use of his images.


Ethical Approval

The study was approved by the Institutional Review Board of the Catholic Medical Center (IRB No. UC22ZASI0055). Patient photographic consent was obtained in written form provided by authors' institution.


Authors' Contributions

Conceptualization: J. K. Resources: S. N. J. Supervision: S. N. J. Visualization: S. N. J., J. K. Writing – original draft: J. K., J. L. Writing – review and editing: S. N. J., B. F. S.




Publication History

Received: 19 May 2022

Accepted: 30 June 2022

Accepted Manuscript online:
07 September 2022

Article published online:
13 December 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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