Abstract: Objective    To investigate the clinical effect of progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation in the repair the transverse defect of fingertip and partial nail bed defect.    Methods    From June 2015 to June 2019, 17 patients with transverse defect of fingertip and nail bed defect were treated with progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation. The area of the affected finger wound was 1.0 cm× 0.8 cm ~ 1.6 cm× 1.5 cm. The fingers were followed-up in function, appearance and incidence of hook nail deformity.    Results   The postoperative follow-up period was 8 to 24 months, 13 months on average. All the 19 flaps survived well. The sensory recovery of 19 flaps reached S4 grade. The reconstructive fingers formed arc-shaped fingertips with nails of good appearance and texture. The appearance of the fingers was satisfactory and the joint movement was normal. The length of the nail bed increased by 2~4 mm, 3.3 mm on average. There was no hook nail deformity in each finger. The excellent rate of nail regeneration was 94%.    Conclusions    Progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation can repair the transverse defect of fingertip and nail bed defect, and reduce the incidence of hook nail deformity while reconstructing the shape of fingertip and nail. It is an effective and simple surgical method for injured finger to reconstruct the shape and function to the maximum extent.

Key words:  Finger injures; ,  ,  Surgical flap; ,  ,  Defect; ,  ,  Nail deformity