Clinical experiences with the modified thenar flap method for 16 fingertip injury cases

The operative methods for fingertip injuries are various. Concerning amputated fingertips, replantation is most favorable. But in many cases, the fingers were crushed and this method results in failure. In such cases we tried the modified thenar flap method, which Nomura et al. reported in 2000, with good results. Between October 2000 and January 2002, 16 patients were operated on with this procedure. Fourteen of 16 patients' reconstructed fingertips were excellent or good. Of these 14, 3 fingers had been constricted on the suture line, 2 had claw nails, 1 had unstable nail, 1 flap seemed bent from the finger axis and 1 flap was too long. All of them showed good reconstruction, though we needed a little correction under local anesthesia in 2 cases. Two of the 16 were poor, because both flaps were of insufficient volume. Only one flexor contraction of the injured finger was observed in a 55-year-old patient and his condition is now improving. None of the patients complained about thenar or hypothenar. To achieve excellent reconstruction of the fingertip using modified thenar flap method, it is important to harvest a large enough flap. We recommend this method for severely crushed fingertip injuries.