Making the V-Y advancement flap safer in fingertip amputations

Amputation of the fingertip is a common injury of the upper extremity. Over the years, a variety of reconstructive techniques have been described. For dorsal oblique and transverse amputations, the Atasoy V-Y advancement flap is a popular choice because it preserves finger length, sensation and function. However, closure under tension remains a problem, putting the flap at risk of partial or full necrosis. To avoid this untoward complication, the classic V-Y advancement technique has been modified to allow for a tension-free closure.