Chimeric tricomposite flap from the second dorsal metacarpal artery

Reconstructing multi-tissue defects in the finger remains a significant challenge in hand surgery. We present the case of a 37-year-old man with segmental loss of bone, skin and extensor apparatus on the dorsal aspect of the index finger. A single stage reconstruction was successfully performed usin...

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Main Authors: Célina Cottier, Sébastien Durand
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JPRAS Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352587825000762
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author Célina Cottier
Sébastien Durand
author_facet Célina Cottier
Sébastien Durand
author_sort Célina Cottier
collection DOAJ
description Reconstructing multi-tissue defects in the finger remains a significant challenge in hand surgery. We present the case of a 37-year-old man with segmental loss of bone, skin and extensor apparatus on the dorsal aspect of the index finger. A single stage reconstruction was successfully performed using a pedicled chimeric flap based on the second dorsal metacarpal artery combining skin paddle, second metacarpal base bone and the extensor indicis proprius. At 12 weeks, proximal interphalangeal joint fusion was achieved and the skin flap healed uneventfully. The patient regained full extension and 20° of active flexion at the distal interphalangeal joint. To our knowledge, this specific chimeric flap has not been previously described in the literature. This technique provides a versatile, single-stage solution for complex dorsal finger reconstruction, minimizing morbidity and optimizing functional outcomes.
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spelling doaj-art-5e400f18dc4a4c8b9741b4ccf3e8a7ab2025-08-20T03:53:56ZengElsevierJPRAS Open2352-58782025-06-014442442910.1016/j.jpra.2025.04.004Chimeric tricomposite flap from the second dorsal metacarpal arteryCélina Cottier0Sébastien Durand1Department of Hand Surgery, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 5, 1011 Lausanne, SwitzerlandCorresponding author.; Department of Hand Surgery, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 5, 1011 Lausanne, SwitzerlandReconstructing multi-tissue defects in the finger remains a significant challenge in hand surgery. We present the case of a 37-year-old man with segmental loss of bone, skin and extensor apparatus on the dorsal aspect of the index finger. A single stage reconstruction was successfully performed using a pedicled chimeric flap based on the second dorsal metacarpal artery combining skin paddle, second metacarpal base bone and the extensor indicis proprius. At 12 weeks, proximal interphalangeal joint fusion was achieved and the skin flap healed uneventfully. The patient regained full extension and 20° of active flexion at the distal interphalangeal joint. To our knowledge, this specific chimeric flap has not been previously described in the literature. This technique provides a versatile, single-stage solution for complex dorsal finger reconstruction, minimizing morbidity and optimizing functional outcomes.http://www.sciencedirect.com/science/article/pii/S2352587825000762Chimeric flapDorsal metacarpal arteryExtensor indicis propriusVascularized tendonVascularized bone graft
spellingShingle Célina Cottier
Sébastien Durand
Chimeric tricomposite flap from the second dorsal metacarpal artery
JPRAS Open
Chimeric flap
Dorsal metacarpal artery
Extensor indicis proprius
Vascularized tendon
Vascularized bone graft
title Chimeric tricomposite flap from the second dorsal metacarpal artery
title_full Chimeric tricomposite flap from the second dorsal metacarpal artery
title_fullStr Chimeric tricomposite flap from the second dorsal metacarpal artery
title_full_unstemmed Chimeric tricomposite flap from the second dorsal metacarpal artery
title_short Chimeric tricomposite flap from the second dorsal metacarpal artery
title_sort chimeric tricomposite flap from the second dorsal metacarpal artery
topic Chimeric flap
Dorsal metacarpal artery
Extensor indicis proprius
Vascularized tendon
Vascularized bone graft
url http://www.sciencedirect.com/science/article/pii/S2352587825000762
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