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Coverage of Fingertip Traumatic Amputation in Lesser Digits With Modified Volar Advancement Flap.

Marvin Man Ting Chung1, Eunice Yik Yee Chow, Wing Yuk Ip

  • 1From the Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR, China.

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
|December 16, 2025
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Summary

A modified volar advancement flap is a viable surgical option for reconstructing fingertip amputations in the lesser digits, offering good sensory recovery with low complication rates.

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Area of Science:

  • Orthopaedic Surgery
  • Hand Surgery
  • Reconstructive Surgery

Background:

  • The Moberg volar advancement flap is traditionally used for thumb defects.
  • Its application in lesser digits for fingertip amputations is less documented.
  • This study investigates a modified flap for these specific injuries.

Purpose of the Study:

  • To evaluate the clinical outcomes of a modified volar advancement flap.
  • To assess its efficacy in reconstructing fingertip amputations in the lesser digits.

Main Methods:

  • Retrospective review of 18 patients undergoing the modified flap for lesser digit fingertip amputations (2015-2021).
  • Exclusion criteria included thumb involvement, non-traumatic causes, and poor follow-up.
  • Mean follow-up was 6 months.

Main Results:

  • Protective sensation in 75%, normal sensation in 43.8%.
  • Mean QuickDASH score of 4.22.
  • Complications: hypersensitivity (61.1%), infection (11.1%), wound dehiscence (11.1%), and fixed flexion deformity (7.1%). No flap necrosis.

Conclusions:

  • The modified volar advancement flap is a feasible technique for lesser digit fingertip reconstruction.
  • It does not require microsurgical skills and can be performed by general orthopaedic surgeons.