Objective: Reliable wound coverage of the fingertip and palmar aspect of the middle finger with a sensate flap in order to restore early function.
Indications: Palmar, oblique pulp defects or amputations at the distal finger phalange with uncovered bone, tendons, and/or neurovascular structures.
Contraindications: Peripheral perfusion deficiency, size of defect exceeding flap capacity, obliteration of the flap artery, i.e. contralateral finger artery.
Surgical technique: Harvesting of adipocutane, midlateral triangle based on proper digital vessel flap; distal flap transposition and primary closure of the harvesting defect, flap dimension 4-5 mm larger than defect.
Postoperative management: Finger splint for 2 weeks, followed by exercises with flap conditioning.
Results: Very reliable defect coverage with 9% minor and temporary complications, all of which healed without consequences.
Keywords: Axial-pattern flap; Fingertip; Fingertip amputation; Lateral advancement flap; Pulp defect.