fig6

Figure 6. A: This patient was referred 48 hours after replantation for impending venous failure. B: A 1.0 cm × 2.5 cm first dorsal metacarpal flap was elevated from the dorsum of the index permitting primary closure of the donor site. The flap eased the circular soft tissue constriction of the thumb and (most importantly) carried two veins restoring the outflow of the thumb (blue arrows). C: Complete survival at two weeks (© Dr. Piñal 2016)^[30].