From November 2008 to March 2015, we performed fingertip reconstructions on 78 fingers (excluding the thumb) of 72 patients using the oblique triangular flap in 29 fingers of 26 patients, volar advancement flap in 8 fingers of 8 patients, reverse digital artery island flap in 16 fingers of 16 patients, thenar flap in 8 fingers of 8 patients, free flap in 7 fingers of 6 patients, and other flaps in 10 fingers of 8 patients. In homodigital flap (oblique triangular flap, volar advancement flap and reverse digital artery island flap) reconstruction, postoperative appearances were excellent in color and texture match; sensory recoveries were favorable. However, postoperative scars and slight joint contractures were sometimes seen on the flap donor sites. In contract, distant flaps (thenar flap) and short pedicle free flaps (posterior interosseous artery perforator flap) showed no postoperative scars in the middle and proximal phalanges levels, and postoperative sensory disturbance (numbness, tingling or hypersensitivity) rarely occurred. Several procedures use flaps for fingertip reconstruction. Thus, one must choose the most appropriate treatment that is tailored to each patient while taking postoperative appearance and flap donor site morbidity into consideration.
