title: Modification of VY flap to preserve fingertip contour.
abstract: 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.
  
  
  CONCLUSIONS
  This modification simplified contouring during flap inset and provided a viable alternative to flap inset and contour adjustment.
authors.affiliation: Department of Orthopaedic Surgery, Hand and Microsurgery Section, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Novena, 308433 Singapore.
authors.forename: Tun Lin
authors.initials: TL
authors.lastname: Foo
authors.forename: Kerry Hiu-Mei
authors.initials: KH
authors.lastname: Wan
keywords: Fingertip; Fingertip amputation; Fingertip defect; Fingertip flap; Fingertip injury; VY plasty