Fingertip Amputations Repair with V-Y Flap and Polyethylene Nail

Abstract

Background: Finger amputations are the most commonly encountered amputation injury in the upper extremities. It is important to avoid shortening and to preserve the length of the finger in fingertip amputations in order not to lose the functions of the hand. The aim of this study was to evaluate the results of our patients who underwent reconstruction using V-Y pulp flap and artificial nail in order to avoid donor site morbidity in fingertip defects.
 Methods: The results of patients who underwent reparation with V-Y flap and polyethylene nails for exposed distal phalanx and partial nail bed defect after fingertip amputation were evaluated in this retrospective study. The data of 44 patients who underwent 44 V-Y advancement flap between January 2016 and January 2021 were retrospectively analyzed.
 Results: A total of 44 patients, 5 female and 39 male, who were treated for fingertip amputation, with a mean follow-up period of 24.2 months (14-71) and a mean age of 34.75 (2-68) were included in the study. The mechanism of injury was guillotine-style, avulsion and crush injuries in 15 (34.1%), 11 (25%) and 18 (40.9%) patients, respectively. Among the patients, 25 (56.8%) had right hand injuries, while 19 (43.2%) had left hand injuries. The dominant hand was affected in 28 (63.6%) patients. In 5 patients, the distal phalanx was shortened to the level of the lost nail bed (shortening was maximum 5 mm). Nail formation had occurred in all patients and deformed nail structure was seen in 18 patients. Graft necrosis was seen in 2 patients.
 Conclusion: It is difficult for surgeons to decide on the treatment method because of the fact that there are multiple surgical techniques in the literature and the results are reported differently. Success rates are high in our technique. Each techniq.ue has its own advantages and disadvantages.