Skip to main content

Advertisement

Log in

Reconstruction of the Fingertip Defect with a Modified Bipedicled Bridge–Type V-Y Advancement Flap

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The traditional V-Y advancement flap for fingertip reconstruction has limitations such as the flap flexibility and distance for advancement. The aim of this study was to design a modified flap to obtain a greater advancement and to provide a far superior cosmetic result. From October 2016 to November 2017, 21 patients underwent the modified flap for fingertip defects reconstruction. A bipedicled bridge type combined with V-Y advancement flap was designed to obtain a greater advancement. We also improved the way of nail groove reconstruction and nail bed lengthening. All the patients were followed up for a minimum of 6 months. All flaps healed with satisfactory pulp and nail contour. All patients were satisfied with the cosmetic appearance and no complications were encountered. The distance of flap advancement can reach to more than 1 cm and flap size can also be larger than 1 cm2. The modified bipedicled bridge–type V-Y advancement flap has simple and acceptable modifications for fingertip reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Atasoy E, Ioakimidis E, Kasdan ML, Kutz JE, Kleinert HE (1970) Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am 52:921–926

    Article  CAS  Google Scholar 

  2. Jackson EA (2001) The V-Y plasty in the treatment of fingertip amputations. Am Fam Physician 64:455–458

    CAS  PubMed  Google Scholar 

  3. Gharb BB, Rampazzo A, Armijo BS, Eshraghi Y, Totonchi AS, Teo TC, Salgado CJ (2010) Tranquilli-Leali or Atasoy flap: an anatomical cadaveric study. J Plast Reconstr Aesthet Surg 63:681–685

    Article  Google Scholar 

  4. Murai M, Lau HK, Pereira BP, Pho RW (1997) A cadaver study on volume and surface area of the fingertip. J Hand Surg 22:935–941

    Article  CAS  Google Scholar 

  5. Foo TL, Wan KH (2012) Modification of VY flap to preserve fingertip contour. Hand. 7:388–390

    Article  Google Scholar 

  6. Foo TL, Wan KH, Chew WY (2012) Safe and easy method to preserve fingertip contour in VY-plasty. Tech Hand Upper Extrem Surg 16:95–97

    Article  Google Scholar 

  7. Foucher G, Delaere O, Citron N, Molderez A (1999) Long-term outcome of neurovascular palmar advancement flaps for distal thumb injuries. Br J Plast Surg 52:64–68

    Article  CAS  Google Scholar 

  8. Shen XF, Xue MY, Mi JY, Qiang L, Rui YJ, Chim H (2015) Innervated digital artery perforator propeller flap for reconstruction of lateral oblique fingertip defects. J Hand Surg 40:1382–1388

    Article  Google Scholar 

  9. Sobanko JF, Fischer J, Etzkorn JR, Miller CJ (2014) Local fasciocutaneous sliding flaps for soft-tissue defects of the dorsum of the hand. JAMA Dermatol 150:1187–1191

    Article  Google Scholar 

  10. Merlino G, Carlucci S (2011) A simple modification of the Bakhach’s eponychial flap for nail lengthening after fingertip amputation. J Plast Reconstr Aesthet Surg 64:e265–e266

    Article  Google Scholar 

  11. Adani R, Marcoccio I, Tarallo L (2003) Nail lengthening and fingertip amputations. Plast Reconstr Surg 112:1287–1294

    Article  Google Scholar 

  12. Wang L, Yuan SY (2012) A simple and direct procedure for excision of peripheral skin above the nail root to enable nail lengthening after fingertip amputation. J Plast Reconstr Aesthet Surg 65:e265–e266

    Article  Google Scholar 

  13. Lee DH, Mignemi ME, Crosby SN (2013) Fingertip injuries: an update on management. J Am Acad Orthop Surg 21:756–766

    Article  Google Scholar 

  14. Germann G, Rudolf KD, Levin SL, Hrabowski M (2017) Fingertip and thumb tip wounds: changing algorithms for sensation, aesthetics, and function. J Hand Surg 42:274–284

    Article  Google Scholar 

  15. Allen MJ (1980) Conservative management of finger tip injuries in adults. Hand. 12:257–265

    Article  CAS  Google Scholar 

  16. Tamai S (1982) Twenty years’ experience of limb replantation--review of 293 upper extremity replants. J Hand Surg 7:549–556

    Article  CAS  Google Scholar 

  17. Park HC, Bahar-Moni AS, Cho SH, Kim SS, Park HS, Ahn SC (2013) Classification of distal fingertip amputation based on the arterial system for replantation. J Hand Microsurg 5:4–8

    Article  Google Scholar 

  18. Koshima I, Urushibara K, Fukuda N, Ohkochi M, Nagase T, Gonda K, Asato H, Yoshimura K (2006) Digital artery perforator flaps for fingertip reconstructions. Plast Reconstr Surg 118:1579–1584

    Article  CAS  Google Scholar 

  19. Moberg E (1964) Aspects of sensation in reconstructive surgery of the upper extremity. J Bone Joint Surg Am 46:817–825

    Article  CAS  Google Scholar 

  20. Panattoni JB, De Ona IR, Ahmed MM (2015) Reconstruction of fingertip injuries: surgical tips and avoiding complications. J Hand Surg 40:1016–1024

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yiheng Chen.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

ESM 1

(DOCX 24 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chi, Z., Chen, Y., Luo, P. et al. Reconstruction of the Fingertip Defect with a Modified Bipedicled Bridge–Type V-Y Advancement Flap. Indian J Surg 82, 142–146 (2020). https://doi.org/10.1007/s12262-019-01906-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-019-01906-3

Keywords

Navigation