Hand soft tissue defects after trauma injuries or tumor excision are challenging for the plastic surgeon, regardless of the patient’s age, gender, or ethnicity. Current surgical protocols suggest protecting the main arteries by using local or free perforator flaps. This article describes the use of local perforator flaps to resurface soft tissue defects with exposed tendons, nerves, arteries and/or bones to obtain the best mobility of the flexion creases without sacrificing the main artery. We present the use of the dorsal metacarpal artery perforator (Quaba) flap in two cases, showing different types of pathology that could benefit from this method. The first case is a 43-year-old male patient, known with psoriasis, who suffered a home accident with a chainsaw. The second case is a 35-year-old woman with a round, mobile skin tumor located on the volar surface of the metacarpophalangeal joint. The patients were discharged from the hospital the next day postoperative. Both patients reported a slight bulkiness of the flap without affecting the functional outcome, preserving full mobility of the fingers. The Quaba flap is a distally based perforator axial flap suitable for soft tissue defects reconstructions, safe and easy to use, with minimal donor site morbidity. Slight bulkiness could affect the aesthetics of the hand.