Original ArticleSensate First Dorsal Metacarpal Artery Flap for Resurfacing Extensive Pulp Defects of the ThumbChang, Shun-Cheng MD; Chen, Shao-Liang MD; Chen, Tim-Mo MD; Chuang, Chia-Jueng MD; Cheng, Tian-Yeu MD; Wang, Hsian-Jenn MDAuthor Information From the Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C. Received February 9, 2004; accepted for publication March 15, 2004. Presented at the Annual Meeting of the Taiwan Association of Surgery, Taipei, March 28, 2003. Reprints: Shao-Liang Chen, Division of Plastic Surgery, Tri-Service General Hospital, 3F, No25, Alley 4, Lane 154, Yung-Chun Street, Taipei 100, Taiwan, R.O.C. E-mail: [email protected] Annals of Plastic Surgery: November 2004 - Volume 53 - Issue 5 - p 449-454 doi: 10.1097/01.sap.0000137134.15728.dd Buy Metrics AbstractIn Brief Finding an appropriate soft-tissue grafting material to close a wound located over the distal phalanx of the thumb, especially the pulp region, can be a difficult task. A sensate first dorsal metacarpal artery flap, mobilized from the dorsum of the adjacent index finger and used as an island pedicle skin flap, can be useful for this purpose. The pedicle includes the ulnar branch of the first dorsal metacarpal artery, the dorsal veins, and the cutaneous branch of the radial nerve. Although this tiny artery is anatomically variable, safe dissection can be achieved by including the radial shaft periosteum of the secondary metacarpal bone and the ulnar head fascia of the first interosseous muscle. This approach has been used for 8 individuals with extensive pulp defects of the thumb over the past 3 years. Skin defects in all patients were combined with bone, joint, or tendon exposure. All flaps survived completely. This 1-stage procedure is reliable and technically simple. It provides sensate coverage to the pulp of the thumb but also avoids nerve repair or more complicated microsurgery. Eight extensive thumb pulp defects were successfully reconstructed with pedicled sensate dorsal metacarpal artery flaps taken from the dorsum of the adjacent index finger. © 2004 Lippincott Williams & Wilkins, Inc.