The adipofascial turn-over flap for coverage of the dorsurn of the finger: A modified surgical technique

Purpose: The exact distances from the cutaneous dorsal branches of the digital artery to proximal interphalangeal joint have been established in a previous anatomic study. The aim of this report is to incorporate these anatomic data into the current way of designing the homodigital adipofascial turn-over flap for cutaneous coverage of the dorsum of the finger. Our clinical experience with this modified surgical technique to this flap is reported. Methods: The clinical series presented here consists of 40 patients with loss of cutaneous coverage at the dorsal aspect of the middle and distal phalanges. Based on our anatomic findings the flap was designed to include at least 1 dorsal branch in its pedicle. Results: The flap survival was excellent and no donor site complications were observed. Conclusions: The adipofascial turn-over arterial flap has appeared as an excellent alternative for achieving early coverage of cutaneous wounds at the dorsal aspect of middle and distal phalanges of the long fingers. This flap can be designed as an arterial flap in a predictable and reliable way based on new anatomic data on the vascularization of the dorsum of the finger. Copyright (C) 2004 by the American Society for Surgery of the Hand.