Abstract
We performed fingertip reconstructions using a local flap or a graft on flap method in un-replantated fingertips as seen in severe crush amputation cases.
Local flaps were performed on 2 thumbs and 4 fingers using 4 oblique triangular flaps, 1 palmar advanced flap and 1 reversed island flap. According to the Ishikawa classification of fingertip amputations, subzone I was in 1, subzone II in 2, subzone III in 2 and subzone IV in 1.
Graft on flap was performed on 6 thumbs and 5 fingers using 10 palmar advancement flaps and 1 oblique triangular flap. Four fingers were subzone II, 5 fingers were subzone III, and 2 fingers were subzone IV.
The patient age range at surgery was 23 to 68 years (mean 45.3 years) and the follow-up range was from 3 to 18 months (mean 8 months).
All flaps survived. Complications after surgery were fingertip numbness in 7 fingers, joint contracture in 10, nail deformity in 6, infection in 4 and nail bed ulcers in 4 after engraftment of graft on flap. Nail bed ulcer cases were healed (3 : by bone shortening, 1 : by medieated bath).
