The retrograde flow Chinese flap has been shown to be a useful cover for extensive losses of palm tissue. We report a case in which vascularization was based on the palmar radiocarpal arch, with angiographic verification, in view of the post-injury absence of palmar arches. Considering the results obtained, the technical modifications introduced with respect to earlier studies are described (flap pivoting 2 cm from the Lister tubercle), and the palmar anastomotic network of the carpal bones is proposed as a new end effective vascular axis in the preparation of retrograde flow antebrachial axial flaps with an intact volar radiocarpal region.