Clinical experiences with the extended first dorsal metacarpal artery island flap for thumb reconstruction.

A single surgical procedure was created to provide composite resurfacing of total volar or dorsal defects of a thumb with normal length. The procedure involved a flap that included the dorsal skin from both the proximal and middle phalanges of the index finger. The flap included the first dorsal metacarpal artery as well as more than 1 dorsal vein (located at the vicinity of the flap pedicle) and terminal dorsal branches of the radial nerve. Harvesting the dorsal skin of both the proximal and middle phalanges of the index finger is considered a modified version of the first dorsal metacarpal artery flap.