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.
J Hand Surg