Ultrathin Oblique Volar-to-Dorsal Reverse Turnover Radial Artery Perforator-Based Adipofascial Flap: A New Surgical Strategy for Reconstructing a Complex Dorsal Hand Tissue Defect

Abstract

Adipofascial flaps used in reconstruction of various tissue defects have been described by many authors and have several advantages. A clinical report of an extensive dorsal hand traumatic soft tissue injury where a new ultrathin oblique volar-to-dorsal adipofascial reverse turnover flap based on radial artery distal perforators is presented. Its width-to-length ratio was 1:4 (the longest ever reported), designed to cover primary free tendon grafts and exposed metacarpal bones. The technique has provided very good hand function and cosmetic outcome, minimum donor site morbidity, shortened rehabilitation, and no complications. Adipofascial flaps constitute a functional and an aesthetic refinement in the reconstructive surgical techniques managing complex tissue defects of the dorsum of the hand, a new surgical strategy reported here. © 2009 Lippincott Williams & Wilkins, Inc.