Dorsal Turnover Adipo-Fascial Homo-Digital Flap, a Versatile Coverage Solution for Exposed Finger's Dorsum

Abstract

A cohort of eleven patients, presenting with fifteen fingers exhibiting soft tissue loss subsequent to trauma or burns, was included in this study. The defects ranged from 20 to 45 mm in length and appeared at various anatomical sites on the dorsal aspect of the fingers. Coverage of exposed structures was achieved utilizing a local dorsal turnover adipo-fascial flap. Soft-tissue coverage was successfully obtained in all cases (n=15). Minor distal partial flap necrosis developed in 20% of procedures (n=3), which was managed effectively with conservative treatment. Partial split-thickness skin graft (STSG) loss occurred in cases with minor flap necrosis and in one additional instance, resulting in an overall incidence of 27% (n=4). All affected areas resolved without requiring secondary grafting. In summary, the dorsal turnover adipo-fascial flap serves as a technically straightforward reconstructive option, yielding satisfactory soft-tissue coverage and aesthetic results within this series. Although some distal flap-related complications occurred, they were limited and managed with conservative measures.