Anatomical basis and clinical application of the dorsal metacarpal cutaneous branch flap of radial digital artery of index finger

This study explored the surgical technique and clinical application of the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.

Through the anatomical dissection of 10 hand specimens, we examined the origin and characteristics of the artery and its branches towards the hand dorsum. Furthermore, the soft tissue defects of the index finger in 12 patients admitted to our hospital between 2017 and 2021 were surgically repaired using the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.

The radial digital artery of the index finger had two types of origins: 70% (14 sides) were derived from the main artery of the thumb, and 30% (6 sides) were derived from the superficial palmar arch. The artery emitted 2 to 4 cutaneous branches from between the origin point and the head of the second metacarpal bone to the skin at the first dorsal interosseous muscle, with a cutaneous branch outer diameter of approximately (0.55 ± 0.01) mm, supplying the skin on the dorsum of the radial side of the hand. Clinical outcomes showed successful flap survival, without any arterial or venous vascular crises. Follow-up examinations at 1 to 3 years postoperatively showed that the skin flap had good blood supply, texture, elasticity, a natural and aesthetic appearance, and no swelling. The protective sensation was recovered and there was no need for secondary repair surgery.

The dorsal metacarpal cutaneous branch flap of the radial digital artery is a safe, reliable option for index finger tissue repair, maintaining palm skin integrity and demonstrating positive clinical efficacy.