[V-y flap for restoration of the fingertip]

Isabella Mehling, Martin H Hessmann, Alexander Hofmann, Pol M Rommens
Operative Orthopädie und Traumatologie 2008, 20 (2): 103-10

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 (Geissendörfer, 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.


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