ABSTRACT
VY-plasty is a well-known technique to reconstruct fingertip defects. A simplified method combining pinning of flap and healing of donor site by secondary intention is described. These steps preserve the rounded appearance of the fingertip and restore the convexity of the hyponychium. Flap ischemia due to suture-line tension is also averted.
Subject(s)
Amputation, Traumatic/surgery , Finger Injuries/surgery , Surgical Flaps , Humans , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Plastic Surgery Procedures/rehabilitationABSTRACT
BACKGROUND: VY flap is a reliable treatment for fingertip amputation injuries. Insetting the flap to replicate fingertip contour can be challenging with the conventional method of using sutures. We propose a modification of inset technique with K-wire to simplify contouring during flap inset. METHODS: Seven patients underwent VY flap reconstruction with the modified inset technique for fingertip defects ranging from 10 × 15 to 20 × 15 mm. The flaps were advanced between 6 and 10 mm and inset with K-wires. The donor site is allowed to heal by secondary intention. At 6 months, static two-point discrimination, sensitivity, and flap appearance were assessed. RESULTS: All flaps healed uneventfully, and each patient returned to work between 8 and 10 weeks. Fingertip and nail contour were satisfactory in every case. CONCLUSION: This modification simplified contouring during flap inset and provided a viable alternative to flap inset and contour adjustment.
