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Quaba Flap for Reconstruction after Cancer Resection of an Amputated Finger Stump.

DOI https://doi.org/ 10.1055/s-0038-1630145. ISSN 0974-3227. ©2018 Society of Indian Hand & Microsurgeons The dorsal metacarpal artery (DMA) perforator flap is a vascular island flap raised on the dorsum of the hand for coverage of finger soft tissue defects. The typical application of this flap is resurfacing the dorsal defect of the finger proximal to the fingertip. The authors present a case that extends the indication for a DMA perforator flap to include resurfacing the stump of an amputated finger. A 76-year-old woman had an intractable ulcer on the stump of her right second finger (►Fig. 1). At the age of 2 years, she suffered a severe burn on her right five digits and underwent surgical amputation of all injured digits at the midlevel of the proximal phalanxes. With a diagnosis of squamous cell carcinoma on biopsy, the tumor was resected to leave an intact margin 5 mm from the border. The stump of the proximal phalanx was exposed after the tumor resection. To repair this defect, a second DMA perforator flap was designed in a 7× 2.5-cm spindle shape. The flap involved a direct skin perforator at the level of the metacarpal neck in the second intermetacarpal space. The flap was elevated, preserving the paratenon of the extensor tendons (►Fig. 2). This perforator-based island flap was rotated 180 degrees