Clinical Example: Dorsal metacarpophalangeal cover with dorsal metacarpal flap

The dorsal metacarpal flaps are based on the dorsal metacarpal arteries. They may be transferred as an island, on a long pedicle such as a flag flap, or as a "supercharged" transposition flap, as in this case.

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This full thickness chemical burn wound in a diabetic smoker had just resolved acute cellulitis.
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Debridement revealed involvement of the metacarpal head. Extensor mechanism, joint capsule and involved metacarpal head were debrided. A bilobed flap was used for cover, using web skin for cover, and index skin for the web.
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The common extensor of the index was transferred to the middle.
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Index donor site covered with a full thickness skin graft.
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Late result:
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