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Use of reverse second dorsal metacarpal artery flap for the treatment of syndactyly of the first web

International Physical Medicine & Rehabilitation Journal
Samuel Ribak,1,2 Frederico Zink,1,2 Bernardo Figueira Althoff,1,2 Ricardo Kaempf de Oliveira3,4


Complex Syndactyly in the hand it is a challenge for surgical corrections. A critical point to assess is the reconstruction of the web space, while scarcity of skin it is often present. The web space should be always planned and designed to bring some function and covering of the deformities. The first web space has an importance to give function on grasping and pinch. In this report, we present a case of a complex syndactyly with a narrow first web space that was reconstructed by the second dorsal metacarpal artery flap. Despite of a critical malformation in the hand, the patient improved his pinch function and showed a good aesthetic outcome. We believe that this flap could be considered an alternative in dealing with this kind of condition and bring a satisfactory solution for web space reconstruction.


syndactyly, first web narrow, flap covering, DMCA flap, Zeta-plasties, flap modification, proximal phalanx, proximal phalanx, dorsal metacarpal arteries, fascia and muscles, widening and deepening, skin grafting, dorsal metacarpal artery, playful techniques