Combination V-Y advancement flap and composite graft for reconstruction of an amputated fingertip

Fingertip amputations can lead to both functional and aesthetic problems. We present the results of our preferred technique to address fingertip amputations in zone 1 and zone 2 which have been deemed non-replantable by microsurgery. It is based on the "reposition technique" described by Dubert et al. in 1997(1) and the free perionychial graft technique suggested by Netscher and Meade in 1999.(2) The technique that we prefer is best described as a combination of an advancement flap and a composite graft. So far seven patients have been treated with this method and our results have been satisfactory in all of them. It is a simple and quick technique that does not require advanced skills and can be done by a well-trained resident or fellow. It allows preservation of finger length, retains the nail and is functionally and aesthetically pleasing.