Pollicisation of the index metacarpal based on the first dorsal metacarpal artery.

We present our experience of two cases in which we carried out pollicisation of the index metacarpal based on the first dorsal metacarpal artery and venae comitans. Both cases were complex severe hand injuries where the initial injury was the result of a firework exploding while held in the hand. In both cases the radial side of the superficial palmar arch was destroyed by the injury. In both cases there was virtually complete loss of the thumb ray and amputation of the index through the base of the proximal phalanx. A useful opposition post has been created from vascularised index metacarpal with free flap soft tissue reconstruction.