Abstract:[Objective] To compare the clinical results of the dorsal branch of digital artery flap (DBDA) and dorsal metacarpal artery return branch flap (DMARB) transfer for the emergency repair of the palmar soft tissue defect on the middle and distal segment of the fin- ger. [Methods] From May 2015 to August 2020, 46 patients received surgical repair of soft tissue defect on the middle and distal segment of the 2 to 5 fingers. According to doctor- patient communication, 25 patients received DBDA flap, while the remaining 21 patient had wound repaired with the DMARB flap. The perioperative conditions and follow-up results of the two groups were compared. [Results] All the patients in both groups had operation performed smoothly without serious complications. The donor area was closed by skin grafting in the DBDA group, while mainly by direct suture in the DMARB group, and the former was significantly inferior to the latter (P＜0.05). Howev- er, there were no significant differences in operation time, flap survival area 1 week after operation, incision healing grade in donor area, su- ture removal time and hospital stay between the two groups (P＞0.05). All patients in both groups were followed up for 9 to 20 months, with an average of (13.6±2.4) months. At the last follow-up, the DBDA group proved significantly superior to the DMARB group in terms of stat- ic two-point recognition and appearance satisfaction scores (P＜0.05), despite of the fact that there was no statistical significance in total ac- tive motion (TAM) between the two groups (P＞0.05). [Conclusion] Both of the two types of flap transfer do effectively repair the soft tissue defects on the palmar side of the middle and distal segments of the finger. By contrast, the DBDA flap achieves better feeling and more cos- metic appearance than the DMARB flap.