Application of the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve for repair of thumb defect

Objective To investigate the clinical efficacy of the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve for repair of thumb defect. Methods From January 2013 to June 2017, 14 patients with thumb defect were treated using the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve. The flap area was 2.0 cm×1.5 cm to 4.5 cm×3.5 cm. The donor area was sutured directly in 11 cases and covered with full thickness skin graft in 3 cases. Results All the 14 flaps were survived uneventfully without vascular crisis, necrosis and infection. The patients were follow-up for 6 to 15 months. The appearance of the fingers was aesthetic, the texture was soft, the skin color was close to the surrounding tissue, and the skin flap had good wear resistance. After the operation, the sensation of the flap recovered to S3+ with the two-point discrimination being 6 to 9 mm. The sensation of pain and temperature were recovered. Patients can use their thumbs for daily work and life. Conclusion The first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve has the advantages of reasonable flap design, reliable blood supply, convenient cutting and simple operation. It is an ideal operation for repairing thumb defect. Key words: Surgical flaps; Treatment outcome; Thumb defect; Superficial branch of radial nerve