The authors study the vascular anatomy of the dorsal adipofascial flap to identify the key points of safe flap dissection. Anatomical dissections of 32 fingers from 6 cadaveric hands were performed after injecting the radial and ulnar arteries with dye. The authors found that the main distal perforators of the flap originated from the digital arteries and were found in an area extending from 5 to 15 mm (mean 7.7 mm) proximal to the eponychial fold.
Dorsal adiposfascial flaps are suitable for coverage of finger tip injuries distal to the eponychial fold. A rectangular flap of skin is elevated and the underlying adipofascial flap is raised from the PIP joint. The adipofascial flap is turned distally and the skin wound is closed over intact paratenon. The findings from this study support preservation of a 10 mm cuff of adipofascial tissue proximal to the eponychial fold in order to avoid vascular compromise.