This paper reports on extensor tenolysis with transfer of an adipofascial flap including the perforator of the dorsal metacarpal artery.
This technique was performed on 5 fingers in 5 cases. Extensor adhesion was caused by proximal phalanx fracture in 3 cases, extensor laceration in 1 case, and dorsal dislocation of PIP joint with central slip laceration in 1 case. The average age of the patients was 43 years, ranging from 20 to 56 years. Injured digits included 4 little fingers and 1 index finger.
The results revealed that the active ROM of PIP and DIP joints improved postoperatively in all cases, but the extension lag of PIP joints deteriorated in 4 cases ( P < 0.05 ).
The pedicled adipofascial flap using the perforator of the dorsal metacarpal artery is effective for preventing extensor adhesion. This technique is quite simple for flap elevation and acceptable for donor site morbidity.
Furthermore, this flap does not include the muscle belly, so the operation can be performed under local anesthesia.
