Dorsal V-Y advancement flap for amputations of the fingertips

Amputations of the fingertip are the most common injuries to the upper limbs, and they cause greatest socioeconomic losses. The first choice of the technique of repair should be the simplest and fastest, with rapid restoration of function and an acceptable aesthetic appearance, and should return the worker to his job rapidly to prevent economic loss. Volar V-Y advancement flaps should therefore be considered first, but unless the dorsal loss is greater than the volar, this first choice of flap cannot be used because of the inadequate donor area. We present here a method for amputations that are proximal to the matrix of the nail. Seven volar oblique or transverse amputations were treated with dorsal V-Y advancement flaps with or without volar V-Y advancement flaps. All flaps survived. The procedure is simple, versatile, and a reliable way of reconstructing amputations of the fingertip that are proximal to the nailbed.