Flaps Based on the Dorsal Metacarpal Artery.

Dorsal metacarpal artery flaps have evolved with our knowledge of vascular anatomy of the hand. Since the description of the first transposition flap likely based on the first dorsal metacarpal artery in the 1950s until today, the indications and modifications of these flaps have greatly expanded. Reverse flow flaps have allowed coverage of the dorsum of each digit with vascularized tissue with minimal donor site morbidity and harvest of veins, bone, and tendon with them. This article reviews the history, anatomy, indications, and surgical techniques of this class of flaps and its numerous permutations.