"Flap-in-Flap" Technique: Double V-Y Flap in Fingertip Injury Management.

Area of Science:

• Hand Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Fingertip amputations are common hand injuries requiring reconstruction.
• Standard V-Y advancement flaps may have insufficient advancement, leading to deformities.
• The double V-Y flap technique utilizes two flaps for enhanced coverage.

Purpose of the Study:

• To evaluate the outcomes of the double V-Y advancement flap for fingertip reconstruction.
• To assess the flap's efficacy in restoring function and aesthetics.
• To determine the safety and simplicity of the double V-Y flap technique.

Main Methods:

• Prospective study of 19 patients with zone II and III fingertip amputations.
• Utilized the double V-Y advancement flap technique.
• Data collected on flap advancement, sensation, range of motion, and complications.

Main Results:

• Average total flap advancement was 12.94 mm.
• Achieved good total active motion (>210 degrees) in all patients.
• One patient experienced minor superficial partial flap necrosis, managed conservatively.

Conclusions:

• The double V-Y advancement flap is a simple and safe method for zone II and III fingertip amputations.
• It provides like-for-like tissue with near-normal sensation.
• The technique effectively restores pulp shape and function, improving aesthetic and functional outcomes.