To explore the clinical effect of reversed island flap pedicled with the third dorsal metacarpal artery branch in the treatment of ulnar defect of middle finger.

From August 2013 to March 2016, 12 cases of ulnar skin and soft tissue defects of middle finger accompanied with exposure of phalanx or tendons were treated by reversed island flap pedicled with the third dorsal metacarpal artery branch. The flap was designed between the wrist of the third dorsal metacarpal artery and the third and fourth metacarpal bones. Flap shape was spindle or oval. The flap areas ranged from 5.5 cm×2.5 cm to 2.5 cm×1.2 cm.

All 12 flaps survived. The flaps showed red and swelling in 3 cases. The heparin calcium was used for 3 days and the antibiotic for 7 days. After about 20 days of wound dressing, blood supply of the flaps returned to normal and the wound healed well. The mean follow-up time was 6.8 months (range, 6 to 9 months). The color, shape, texture, elasticity of the flaps was good without tenderness. No obvious discomfort in donor site. Two-point discrimination of flaps ranged from 7 to 11 mm, with an average of 9.3 mm. According to upper extremity function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the total active movement of middle finger was 209.27±15.10. The results were graded as excellent in 7 cases and good in 5 cases.

Reversed island flap pedicled with the third dorsal metacarpal artery branch is a useful method to repair ulnar defect of middle finger because of the good blood supply, appearance and sensory recovery.

Finger injuries; Surgical flaps; The third dorsal metacarpal artery; Defects