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Yamakawa et al. Plast Aesthet Res 2020;7:24 I http://dx.doi.org/10.20517/2347-9264.2020.20 Page 7 of 11

A B

C D

E F

Figure 7. A 62-year-old man with skin and extensor tendon avulsion on the dorsum of his index finger. A: the index MP joint was
exposed; B: design of the forearm adipofascial flap along the radial artery; C: raising of the forearm adipofascial flap, including the
palmaris longus tendon; D: interlacing suturing of the extensor digitorum tendon and palmaris longus tendon; E: split-thickness skin
grafting over the adipofascial flap; F: the flap donor defect was closed

tendons or bones are exposed or lost, soft tissue reconstruction using a flap with good circulation is
required to resurface the defect. We were able to reconstruct the defects of blood vessels, nerves, and
tendon by the adipofascial flap with forearm tissue. In case 2, the radial artery perforator adipofascial flap
with the palmaris longus tendon was selected for reconstruction of the dorsal hand defect and the defect of
the extensor indicis muscle tendon.