Volar adipofascial flap for fingertip defects

Abstract

Objectives Adipofascial flap is one of the options for finger defect reconstruction. Dorsal finger adipofascial flaps have been reported in the literature, but volar adipofascial flaps are rarely used. In this article, we describe our fingertip reconstruction technique using volar adipofascial flap coverage, followed by skin or amputated part composite grafting. We performed a retrospective analysis of the survival and functional results of 23 flaps in 21 patients. Methods Operational records were retrospectively scanned for cases of volar adipofascial flap application. Patients with a follow-up time of less than 6 months and those younger than 18 years old were excluded. All the patients were evaluated during the final follow-up period. Demographic data, operated fingers, type of skin graft (composite tissue from the amputated part or other donor site), follow-up time, and time to return to work were recorded. The functional results and complaints were assessed. Results Flap or skin graft total necrosis, which required reconstruction using another procedure, was not observed in any case. Only one finger had a PIP flexion contracture of 15 °. All other fingers achieved full extension. Five patients complained of fingertip hypersensitivity in six fingers (%26.1). The mean return to work time was 3.3 months (2-8). Conclusion Volar adipofascial flap combined with skin or composite grafting is a simple choice for fingertip defects. Avoiding PIP flexion contractures is an advantage. Disadvantages include hypersensitivity and a prolonged healing period. This flap can be used in selected patients to avoid more complex reconstruction procedures.