Clinical outcomes of the oblique V-Y advancement pulp flap for repair of lateral fingertip injuries.

Abstract

We report the use of obliquely oriented V-Y advancement pulp flaps to reconstruct 17 consecutive, lateral oblique fingertip traumatic defects over a 2-year period. All flaps survived completely with no bone protuberance, prominent scar or neuroma evident at an average follow-up of 11 months (range 7 to 19). Although there was no incidence of severe hook nail deformities, there were two patients who had residual mild hook nails, two with pulp/nail asymmetries and one with an ingrown nail. The mean static two-point discrimination was 3.9 mm (range 2 to 8) and the mean Semmes-Weinstein monofilament test score 3.6 g (range 2.44 to 4.56). No correlation was found between the flap obliquity angle and sensory test results. We recommend the obliquely oriented V-Y pulp flap as a reliable reconstructive option for the cover of lateral oblique fingertip defects.Level of evidence: IV.