Reverse dorsal metacarpal flaps for reconstruction of proximal phalanx defects following skin tumor excision: A case series

Background: Reverse dorsal metacarpal flaps (RDMFs) are widely used to cover significant skin and soft tissues defects of the finger.However, there is a current lack of information regarding the use of RDMFs in the reconstruction of phalanx defects following skin tumor excision. Methods: From October 2012 to April 2016, medical records of all patients who underwent reconstruction of proximal phalanx defects with RDMF were retrospectively reviewed. Patient age and gender, tumor type, tumor location, donor site coverage, flap dimensions, range of motion of the metacarpophalangeal joint, and postoperative complications were evaluated. Results: Seven patients underwent closure of skin defects of the proximal phalanx with RDMF. All flaps survived completely without complication. Flap size ranged from 1.5 × 2 to 3 × 3.5 cm. Good coverage was obtained in all cases. Skin paddle was taken from the dorsal aspect of the second, third, and fourth intermetacarpal area. All patients had full range of movement of the reconstructed and donor digits when followed at 6 months after surgery. Conclusions: The RDMF is a flap which is safe, easy to apply in the context of soft tissue coverage procedures, and does not result in the loss of finger functions. It also confers excellent aesthetic skin suitability and does not require debulking procedures. Level of Evidence: Level V, therapeutic study. © 2017, Springer-Verlag Berlin Heidelberg.