V-Y Plasty as Treatment of Finger Tip Amputations

A Systematic Review of Outcomes of Revision Amputation Treatment for Fingertip Amputations

“…In addition, there is considerable variability in techniques used for fingertip revision amputation. Eighteen studies used the homodigital island flap [1-3, 6, 14, 15, 21, 26-29, 37, 40, 43, 44, 47, 49, 52], whereas seven studies reported V-Y advancement flap [4,5,17,18,39,41,46] and another two studies reported cross-finger flap treatment [9,46]. Three studies treated fingertip amputations with dressings and allowed wounds to heal by secondary intention [13,16,30].…”

Digital Tip Amputations from the Perspective of the Nail

“…Trimming the bony support of the nail bed shortens the finger and increases the hook deformity. Primary closure may prevent the nail bed distraction that occurs when fingertips heal by secondary intention, and repair under tension increases the risk for cold intolerance and pulp tenderness [5, 9, 11, 19, 22, 28, 30]. …”

“…Local flaps [9, 18, 20, 23, 26, 31, 36–40] are tedious to perform and are associated with risk of flap failure [20, 30, 37, 40–43]. Furthermore, iatrogenic sensory loss is common even when experienced hand surgeons perform the surgery [22, 26, 36, 44].…”

“…In spite of its simplicity, the method requires adherence to a few basic principles. It is important not to remove bony support since this increases hooking of the regrowing nail [5, 17, 30, 38, 42, 62]. Sharp bone spicules can be trimmed, but a 1–3 mm protrusion of the phalanx rarely causes problems [1, 16].…”

The Spiral Flap for Fingertip Resurfacing: Short-Term and Long-Term Results

“…1E) allowing the flap to advance further distally, in a manner similar to a V-Y neurovascular island advancement flap. 11 Up to 2-cm advancement is possible with this technique. A donor defect 1.5 to 2.0 cm long ϫ 0.5 to 1.0 cm wide is created over the dorsum of the middle phalanx.…”