To summarize the operative procedure and clinical efficacy of the first dorsal metacarpal artery flap for repair of the finger soft tissue defects with bone and tendon exposure by free transplantation.

From June 2014 to June 2017, 10 cases of the finger soft tissue defects with bone and tendon exposure were treated by the first dorsal metacarpal artery flap transplantation, and the sensation of the flap was reconstructed using the superficial branch of the radial nerve. The area of the flap ranged from 1.5 cm×4.5 cm to 5.2 cm×6.0 cm. The donor sites were closed directly or by skin graft.

All the flaps survived successfully without vascular crisis. Primary healing of the flaps and donor sites was achieved. All the cases were follow-up for 6 to 20 months, with an average of 10 months. The shape and color of the flap were close to the healthy side, and the texture was soft. Two-point discrimination was 7 to 12 mm with an average of 8.5 mm. Hand function was evaluated by the total active range of motion of the fingers. The results were excellent in 6 cases, good in 3 cases and fair in 1 case.

The free first dorsal metacarpal artery flap, which selectively included the superficial branch of the radial nerve, is a reliable and simple procedure. It can effectively cover the wound with lighter injury in donor site and obtain an ideal appearance, function and sensory recovery.

Finger injuries; Surgical flaps; Microsurgery; The first dorsal metacarpal artery