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Journal of Hand Surgery (British and European Volume)
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Articles

Reconstruction of Fingertip Defects with the Neurovascular Tranquilli-Leali Flap

P. LORÉA
N. CHAHIDI
S. MARCHESI
R. EZZEDINE
F. MARIN BRAUN
M. DURY

From the Sos Main Strasbourg Centre, France and the Center for Hand Surgery, Clinique Parc Leopold, Brussels, Belgium

Correspondence: Dr P. Loréa, SOS Main Strasbourg Centre, Clinique Diaconat, 4, rue Ste Elisabeth, 67000 Strasbourg, France. Tel./fax: +33 388 354 500. E-mail: loreapatrick{at}yahoo.fr

For many years, bipedicled palmar advancement flaps were used rarely in fingers because they sacrificed the dorsal branches of the digital arteries, risking dorsal skin necrosis. In 1995, a short bipedicled neurovascular VY advancement flap raised distally to the PIP flexion crease, which spared the dorsal blood supply, was described by Elliot et al. (1995). This paper includes an anatomical study on 28 fresh cadaver fingers to evaluate the advancement potential of this flap. It also reviews 22 fingertip reconstructions in 22 patients using this flap. The mean advancement of the flap in the cadaver study was 14 (range 10–16) mm. This procedure gave good clinical results in respect of healing, sensibility, bone cover and appearance. Complications occurred in four fingers (18%), viz. two infections, one neuroma and one stiff proximal interphalangeal joint. Our study suggests that this flap can be used to treat fingertip defects of a size of approximately half of the pulp of the distal phalangeal segment of the finger.

Key Words: digital amputation • island flap • VY flap • pulp reconstruction • anatomy

Journal of Hand Surgery (British and European Volume), Vol. 31, No. 3, 280-284 (2006)
DOI: 10.1016/J.JHSB.2005.11.007
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