Modification of VY flap to preserve fingertip contour

Background

VY flap is a reliable treatment for fingertip amputation injuries. Insetting the flap to replicate fingertip contour can be challenging with the conventional method of using sutures. We propose a modification of inset technique with K-wire to simplify contouring during flap inset.

Methods

Seven patients underwent VY flap reconstruction with the modified inset technique for fingertip defects ranging from 10 × 15 to 20 × 15 mm. The flaps were advanced between 6 and 10 mm and inset with K-wires. The donor site is allowed to heal by secondary intention. At 6 months, static two-point discrimination, sensitivity, and flap appearance were assessed.

Results

All flaps healed uneventfully, and each patient returned to work between 8 and 10 weeks. Fingertip and nail contour were satisfactory in every case.

Conclusion

This modification simplified contouring during flap inset and provided a viable alternative to flap inset and contour adjustment.