Adipofascial turnover flap for the coverage of the dorsum of the thumb: an anatomic study and clinical application

The purpose of this report is to show how our anatomical findings have influenced the design of the dorsal homodigital adipofascial turnover arterial flap to the thumb. Thirty-six thumbs from 18 fresh cadavers were dissected at the Fèr à Moulin Laboratoire (Paris, France) between January 1998 and Ma...

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Bibliographic Details
Published inThe Journal of hand surgery, European volume Vol. 38; no. 4; p. 371
Main Authors Silva, J Braga, Faloppa, F, Albertoni, W, Gazzalle, A, Cunha, G L da
Format Journal Article
LanguageEnglish
Published England 01.05.2013
Subjects
Adipose Tissue - transplantation
Adult
Cadaver
Dissection
Esthetics
Fascia - transplantation
Female
Humans
Male
Soft Tissue Injuries - surgery
Surgical Flaps
Thumb - blood supply
Thumb - injuries
Thumb - surgery
Treatment Outcome
Wound Healing - physiology
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Summary:The purpose of this report is to show how our anatomical findings have influenced the design of the dorsal homodigital adipofascial turnover arterial flap to the thumb. Thirty-six thumbs from 18 fresh cadavers were dissected at the Fèr à Moulin Laboratoire (Paris, France) between January 1998 and March 1999. All branches of the proper digital artery (PDA) were identified. During the clinical study, from 2002 to 2008, 12 patients with dorsal thumb skin defects were treated with adipofascial turnover flaps. The dorsal branches of the PDA typically emerge at the level of the metacarpophalangeal and interphalangeal joints, 10 mm apart from the joint line. Based on the anatomical study, the flap could be designed predictably and reliably. The main advantages of dorsal adipofascial turnover flaps include their simplicity; the possibility of a one stage procedure; avoiding the use of tissue from elsewhere on the limb/body; minimal donor-site deformity; and avoidance of damage to the volar digital arteries.
ISSN:2043-6289
DOI:10.1177/1753193412439168