Reconstruction of the Fingertip Defect with a Modified Bipedicled Bridge-Type V-Y Advancement Flap

The traditional V-Y advancement flap for fingertip reconstruction has limitations such as the flap flexibility and distance for advancement. The aim of this study was to design a modified flap to obtain a greater advancement and to provide a far superior cosmetic result. From October 2016 to November 2017, 21 patients underwent the modified flap for fingertip defects reconstruction. A bipedicled bridge type combined with V-Y advancement flap was designed to obtain a greater advancement. We also improved the way of nail groove reconstruction and nail bed lengthening. All the patients were followed up for a minimum of 6 months. All flaps healed with satisfactory pulp and nail contour. All patients were satisfied with the cosmetic appearance and no complications were encountered. The distance of flap advancement can reach to more than 1 cm and flap size can also be larger than 1 cm(2). The modified bipedicled bridge-type V-Y advancement flap has simple and acceptable modifications for fingertip reconstruction.