Dorsal metacarpal flaps.

The history of dorsal metacarpal flaps and their anatomical basis is described. In thirty hand dissections, the fascial variety of the first dorsal metacarpal artery was present in 90% and the second dorsal metacarpal artery in 97%. The origin, course, branches and termination of these arteries are illustrated. Doppler ultrasonic flowmeter studies of the vessels in 52 hands are presented but shown to be unhelpful clinically. Two patients in whom the second dorsal metacarpal flap was used, are described and possible difficulties delineated.