Objective:

To present a structured loco-regional protocol for managing complex dorsal finger injuries through a combination of tendon reconstruction and soft-tissue coverage.

Approach:

• Surgical Technique: Involves stabilization of interphalangeal joints, harvesting of juncturae tendinum, fixation of grafts, and coverage with an adipofascial axial turnover flap, followed by standardized postoperative immobilization and rehabilitation.

Key Findings:

• The adipofascial arterial turnover flap is axial, relying on dorsal cutaneous branches from the proper palmar digital arteries.
• Juncturae tendinum can be effectively harvested for tendon reconstruction, particularly Type 3 tendinous bands, as demonstrated in the cases reviewed.

Interpretation:

The protocol provides a method for reconstructing complex dorsal finger defects, combining tendon repair and soft-tissue coverage in a single operative stage.

Limitations:

• Exclusion of chronic or infected wounds, prior surgeries, and incomplete follow-up data may limit the generalizability of the findings.

Conclusion:

The study presents a method for treating complex dorsal finger defects, emphasizing the importance of local solutions.

Sources:

• Braga-Silva et al. (2004)