The first dorsal metacarpal flap in first web space and thumb reconstruction.

Small local flaps for reconstruction of contractures or defects on the hand are useful. The first dorsal metacarpal flap from the dorsal surface of the proximal index is a convenient local flap in hand surgery. The flap may include the dorsal vein and, most importantly, the cutaneous branch of radial nerve. Although there may be some variations of the vascular pedicle, the flap is reliable using careful dissection. In a series of 15 patients, reconstruction with this flap was successful except for 1 patient with marginal necrosis. The first dorsal metacarpal flap is a reliable and convenient local flap in reconstruction of defects or contracture on the thumb and first web space.