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Surgical technique| Volume 42, ISSUE 12, P1040.e1-1040.e7, December 2017

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A Technique for Tripartite Reconstruction of Fingertip Injuries Using the Thenar Flap With Bone and Nail Bed Grafts

      Fingertip amputation is the most common amputation encountered by hand surgeons. Treatment decisions are multifactorial, based on mechanism, level of injury, tissue loss, associated injuries, and patient preference, among others. In this article, we present use of the thenar flap in combination with bone graft and split-thickness nail bed graft to address the tripartite loss of distal phalanx, soft tissue, and nail bed. This method allows for a full-length and functional reconstructed fingertip that is aesthetically satisfactory and does not require microsurgical techniques.

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      References

        • Atasoy E.
        • Ioakimidis E.
        • Kasdan M.L.
        • Kutz J.E.
        • Kleinert H.E.
        Reconstruction of the amputated finger tip with a triangular volar flap.
        J Bone Joint Surg Am. 1970; 52: 921-926
        • Brown R.E.
        • Zook E.G.
        • Russell R.C.
        Fingertip reconstruction with flaps and nail bed grafts.
        J Hand Surg Am. 1999; 24: 345-351
        • Cohen B.E.
        • Cronin E.D.
        An innervated cross-finger flap for fingertip reconstruction.
        Plast Reconstr Surg. 1983; 72: 688-695
        • Flatt A.E.
        The thenar flap.
        Bone Joint J. 1957; 39: 80-85
        • Hattori Y.
        • Doi K.
        • Sakamoto S.
        • Yamasaki H.
        • Wahegaonkar A.
        • Addosooki A.
        Fingertip replantation.
        J Hand Surg Am. 2007; 32: 548-555
        • Ishikawa K.
        • Ogawa Y.
        • Soeda H.
        • Yoshida Y.
        A new classification of the amputation level for the distal part of the finger.
        J Jpn Soc Microsurg. 1990; 3: 54-62
        • Lee D.C.
        • Kim J.S.
        • Ki S.H.
        • Roh S.Y.
        • Yang J.W.
        • Chung K.C.
        Partial second toe pulp free flap for fingertip reconstruction.
        Plast Reconstr Surg. 2008; 121: 899-907
        • Hsieh S.C.
        • Chen S.L.
        • Chen T.M.
        • Cheng T.Y.
        • Wang H.J.
        Thin split-thickness toenail bed grafts for avulsed nail bed defects.
        Ann Plast Surg. 2004; 52: 375-379
        • Yong F.C.
        • Teoh L.C.
        Nail bed reconstruction with split-thickness nail bed grafts.
        J Hand Surg Eur Vol. 1992; 17: 193-197
        • Melone C.P.
        • Beasley R.W.
        • Carstens J.H.
        The thenar flap—an analysis of its use in 150 cases.
        J Hand Surg Am. 1982; 7: 291-297