V-Y flap for restoration of the fingertip

Objective Restoration of the fingertip with a neurovascular V-Y flap. Indications Transverse or oblique defects of the fingertip, also with exposed bone of the distal phalanx. Contraindications Larger defects of the phalanx over the proximal interphalangeal joint. Crush injury of the finger. Preexisting lesions of the fingertip. Circulatory disorder. Contamination. Infection of the finger. Surgical Technique A single volar ( Tranquilli-Leali, Atasoy) or a bilateral V-Y flap ( Geissendorfer, Kutler) is used for restoration of the fingertip. The incision is V-shaped and will be converted to a Y, as the flap is advanced. The subcutaneous tissue of the flap contains neurovascular structures, and provides sensibility and padding of the fingertip. A distal advancement of the flap up to 10 mm is possible with this technique. Postoperative Management Immobilization in a two-finger splint for 1 week. Results Good functional results.