The reverse dorsal metacarpal flap.

The dorsal metacarpal vessels contribute to the fascial plexus which supplies the skin of the dorsum of the hand. We have successfully used eight reverse dorsal metacarpal flaps based on the dorsal metacarpal arteries. The design and use of the reverse dorsal metacarpal flap is described; it appears to have a reliable vascular basis and its usefulness in covering small soft tissue defects in the hand is illustrated.