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

The Moberg volar advancement flap was classically described for covering thumb defects following traumatic fingertip amputations. However, its use in the lesser digits has been rarely reported. This study aims to evaluate the clinical outcomes of a modified volar advancement flap for fingertip amputations in lesser digits.

A single-center retrospective review was conducted on patients who underwent a modified volar advancement flap for fingertip amputation reconstruction of the lesser digits between 2015 and 2021. Patients who had flaps performed for the thumb, nontraumatic causes (eg, infection or gangrene), or who defaulted on postoperative rehabilitation and follow-up were excluded.

Eighteen patients met the inclusion criteria for analysis, with a mean follow-up duration of 6 months. Protective sensation was achieved in 75% of patients, whereas 43.8% regained normal sensation. The mean QuickDASH score was 4.22 ± 5.97 (range 0 to 18.18). Common complications included hypersensitivity (61.1%), infection (11.1%), wound dehiscence (11.1%), and fixed flexion deformity of the distal interphalangeal joint (7.1%). No cases of flap necrosis or dorsal skin necrosis were observed.

The modified volar advancement flap remains a feasible option for reconstructing fingertip amputations, even in the lesser digits. This technique does not require microsurgical expertise and can be safely performed by general orthopaedic surgeons.