Reconstruction of Finger Tip Amputations with Advancement Flap and Free Nail Bed Graft

Author(s): Sabapathy SR, Venkatramani H, Bharathi R, Jayachandran S

Source: J Hand Surg 27B: 134-138, 2002


The authors reviewed 15 fingertip amputations which were treated by palmar V-Y advancement flaps and full thickness nail bed grafts from the amputated parts.  The undersurface of the V-Y flap was sutured to the nail bed remnant and the raw area was covered with free matrix tissues.  The technique resulted in an average gain of 5 mm of extra length to the nail.

Several different techniques are available to address finger tip amputations.  Often simple is better, both in lowering morbidity and in returning individuals to a more rapid functional recovery.  Local soft-tissue options, such as the V-Y advancement are helpful, especially when there is more soft-tissue loss palmarly and when more than approximately 50% of the sterile matrix remains.  Otherwise, a revision amputation is often preferred.  The authors remind us that “spare parts” are occasionally available and may improve cosmesis in select injury patterns.



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J Hand Surg