Alternative Techniques

The lateral V-Y flap technique uses flaps from the lateral side of the digit to close fingertip defects. Digital anesthesia is obtained with metacarpal block. The bone is debrided and the wound is irrigated. The dorsal incision is made from the amputation site to 2 mm lateral to the nail fold and continued proximally midway between the palmar and dorsal surfaces of the bone. The incision length is twice the width of the flap. The oblique incision is made from the palmar edge of the defect to intersect with the dorsal incision (Fig. 37—5). Advancement of the flaps requires complete release of the dorsal-lateral fibrous bands (Fig. 37—6). With tension on the distal aspect of the flap, the fibrous septum is dissected. The two flaps are advanced

Dorsal Oblique Nail Bed
Figure 37—6. Advancement of the flaps requires complete release of the dorsal-lateral fibrous bands.
Advancement Flap

Figure 37—7. The two flaps are advanced toward each other and sutured together and to the nail bed.

Figure 37—7. The two flaps are advanced toward each other and sutured together and to the nail bed.

toward each other and sutured together and to the nail bed (Fig. 37—7). Postoperative care is similar to the volar V-Y technique.

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