Clinical Scorecard: Utilizing a perforator-based axial adipofascial turnover flap alongside juncturae tendinum grafting for intricate dorsal phalangeal reconstructions

At a Glance

Key Highlights

• Combines tendon reconstruction with soft-tissue coverage in one operative stage
• Employs a structured loco-regional protocol for complex dorsal finger injuries
• Utilizes local tissues to minimize procedural complexity and morbidity
• Involves stabilization of interphalangeal joints and graft fixation under adjusted tension
• Standardized postoperative immobilization followed by rehabilitation

Guideline-Based Recommendations

Diagnosis

• Assess for acute traumatic dorsal digital defects with exposure of bone, tendon, or joint

Management

• Implement a sequential management protocol including joint stabilization, tendon grafting, and soft-tissue coverage

Monitoring & Follow-up

• Follow-up for proper healing and function restoration post-surgery

Risks

• Potential for complications such as infection or inadequate coverage leading to disability

Patient & Prescribing Data

Patients with acute traumatic injuries to the dorsal aspect of fingers

Focus on individualized planning to balance reliability and technical requirements

Clinical Best Practices

• Utilize the reconstructive ladder principle to choose the least complex effective approach
• Ensure thorough debridement and evaluation of defects before reconstruction
• Maintain appropriate tension during tendon graft fixation

Related Resources & Content

• Braga-Silva et al. (2004)
• Govsa et al.