ABSTRACT
Thumb pulp defects are commonly due to avulsion injuries. It is very important to
reconstruct these defects using sensate flaps as the thumb pulp needs to be sensate
for implementing the various functions of the thumb. A very good option for coverage
of these defects is the islanded first dorsal metacarpal artery flap. Our study was
done over a period of 2 years and involved 9 consecutive cases of thumb pulp defects
treated at our institution. The patients included 8 males and 1 female, ranging in
age from 16 to 51 years old. The flap size ranged from 2 × 1.5 cm to 5 × 3 cm. We
had only one complication in the form of partial flap necrosis, which fortunately
healed following debridement without the need for a secondary procedure. All our cases
were done under local anesthesia with tourniquet control. All the patients had good
fine touch and average two-point discrimination of 6 mm, which was satisfactory. Our
good results further reinforce the islanded first dorsal metacarpal artery flap as
one the best flaps for sensate reconstruction of thumb pulp defects. It replaces the
soft tissue loss at the thumb pulp with minimal donor site morbidity and with good
return of thumb pulp sensation.
KEY WORDS
First dorsal metacarpal artery flap - Thumb pulp defect - Sensate flap
