We treated two patients with skin defects of the phalanges using folded venous flaps. The size of the skin defect was measured, and a skin flap half as wide and twice as long as the defect was designed as an A-V type venous flap. In Case 1, a 23-year-old man with fingertip amputation of his little finger, the flap was used to wrap the distal phalanx. In Case 2, a 62-year-old man with a radial skin defect of the distal phalanx of his middle finger, the defect was covered after osteosynthesis of the distal phalanx. Both cases were successful. The advantages of this technique include: the ability to secure both the inflow arterial and outflow venous vessels at the same site, similar to a free arterial flap; the narrow width of the skin flap stabilizes blood flow, facilitating closure on the donor side; and the skin flap can be harvested from the same operative field.
