Outcome and Utility of First Dorsal Metacarpal Artery Flap for Finger Defects
Background: The First Dorsal Metacarpal Artery (FDMA) Flap or Foucher’s flap is an island pedicle flap proximally based on the first dorsal metacarpal artery and veins. A branch of radial sensory nerve is incorporated in the flap to make it a sensate flap. Objective: The aim of our study was to evaluate the functional and aesthetic outcomes of the seven FDMA flaps done over a period of four years for reconstruction of the distal thumb soft tissue defects and one defect over proximal phalanx of the index finger. Methods: This prospective study was performed between 2018 and 2022 at the Clinic of Reconstructive and Plastic Surgery. We present a series of six cases of distal thumb soft tissue defects and one patient with defect over the dorsal aspect of the index finger that were reconstructed with the FDMA flap. Results: In six patient donor site was grafted by full-thickness skin graft harvested from the groin and in one case was closed primary. All flaps survived and one case that was closed primary had donor site complication that was related to primary closure of the skin. All the patients had good fine touch and average two-point discrimination of 8.7 mm. Conclusion: FDMA flap is a useful and reliable flap to cover the defects of the dorsal aspect and to a certain extent the volar aspect of the thumb. We showed that can be used to cover the defects over proximal phalanx of the index finger. The flap provides adequate soft tissue coverage and good aesthetic results.