Original ArticlesStepladder Dorsal Metacarpal Flaps for Dorsal Finger and Hand ReconstructionOkada, E. MD; Maruyama, Y. MD; Hayashi, A. MDAuthor Information From the Department of Plastic and Reconstructive Surgery, Toho University School of Medicine, Tokyo, Japan. Received May 11, 2001, and in revised form Jul 5, 2001. Accepted for publication Jul 5, 2001. Address correspondence and reprint requests to Dr Okada, Department of Plastic and Reconstructive Surgery, Toho University School of Medicine, 6-11-1 Ohmorinishi, Ohta-ku, Tokyo 143, Japan. Okada E, Maruyama Y, Hayashi A. Stepladder dorsal metacarpal flaps for dorsal finger and hand reconstruction. Ann Plast Surg 2002;48:48–52 Annals of Plastic Surgery: January 2002 - Volume 48 - Issue 1 - p 48-52 Buy Abstract The authors demonstrate successful cases of stepladder dorsal metacarpal V-Y advancement and rotation-advancement flaps for reconstructing defects on the dorsum of the finger and hand. One side of the flap is designed in a multilobed shape, and each lobed flap is designed on the dorsum of adjacent fingers. These flaps are supplied by dorsal metacarpal vessels. Consequently, this method has the elements of the stepped incision technique, in combination with the V-Y and rotation-advancement principle. All flaps survived completely. This technique may be a useful option for reconstruction of defects of the dorsum of the finger and hand. © 2002 Lippincott Williams & Wilkins, Inc.