title: Fingertip reconstruction with simultaneous flaps and nail bed grafts following amputation.
abstract: OBJECTIVE
  To report our technique and results with treating fingertip amputations with flaps and simultaneous nailbed grafts.
  
  
  METHODS
  We reconstructed 20 fingertip amputations with loss of bone and nail with flaps combined with nailbed grafts. We reconstructed the volar side of the fingertip with a flap, and the dorsal side of the fingertip with a nailbed grafted to the raw inner surface of the flap. We employed volar V-Y advancement flaps for transverse or dorsal oblique fingertip injuries and generally used abdominal flaps for volar oblique fingertip injuries. We harvested nailbeds from the amputated finger or from the patient's first toe.
  
  
  RESULTS
  The length of the amputated fingertips was restored with the flaps, and the lost nailbeds were restored to their natural appearance with the nailbed grafts. We classified the results according to the length of the reconstructed fingertip and the appearance of the nail. Excellent or good results were achieved in 16 cases. Three cases had fair results and 1 had a poor result. We observed favorable results for distal fingertip amputations (Allen type II or III). In particular, most cases that were reconstructed with volar V-Y advancement flaps combined with nailbed grafts demonstrated favorable results.
  
  
  CONCLUSIONS
  This method is useful for the restoration of dorsal oblique or transverse type fingertip amputations and is a good alternative when replantation is not an option.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University, Seongnam, Korea.
authors.forename: Euna
authors.initials: E
authors.lastname: Hwang
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Park
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Song
authors.forename: Ho Sung
authors.initials: HS
authors.lastname: Jung
authors.forename: Chung Hun
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome