The present study evaluated the clinical efficacy of reverse second and third dorsal metacarpal artery fasciocutaneous flaps for repair of distal- and middle-segment finger soft tissue defects. A total of 14 patients with distal- and middle-segment finger soft tissue defects complicated by exposure of the phalanx or tendon were repaired using second and third dorsal metacarpal artery fasciocutaneous flaps ranging between 2.0 cm x 4.5 cm and 3.0 cm x 7.0 cm. All of the skin flaps survived after surgery. Follow-up data during a 6- to 40-month period showed that the flaps exhibited a satisfactory appearance. They were not fat or clumsy, with a 2-point discrimination of 5 to 9 mm, and there was good recovery of finger function. The donor site was able to be directly sutured without dermoplasty. Pigmented linear surgical streaks appeared in the donor site. The second and third dorsal metacarpal artery fasciocutaneous flaps provide a good approach for the repair of distal-and middle-segment finger soft tissue defects and functional reconstruction because of convenient dissection, little trauma, sufficient use of the dorsal metacarpal artery, large harvested area of the flap, and a good dissection range.