Hypothenar skin grafts for fingertip reconstruction

Full-thickness skin grafts from the hypothenar area were used to reconstruct 25 digits in a group of 20 patients. The results were evaluated objectively and subjectively at an average of 9.5 months after operation for sensibility, durability, and appearance. Eighty-six percent of the patients had two-point discrimination of 10 mm or less, with one half of them having two-point discrimination of less than 6 mm. All patients had good protective coverage and no ulcer formation. All patients could differentiate between coarse and smooth texture, although only one third had texture discrimination equal to that of normal digits. None of the patients complained of hypersensitivity. The donor site was cosmetically acceptable in all cases. The use of hypothenar full-thickness grafts provides an acceptable method for fingertip reconstruction, particularly in instances of palmar and lateral pulp loss in which there is insufficient tissue available for local advancement.