Local neurovascular island flap.

Fingertip amputation, with loss of the terminal pulp and bone exposure presents a difficult problem. Reconstruction with use of a local neurovascular island flap has been done in twenty-one patients to restore sensibility and function with preservation of length. All patients achieved two-point discrimination values within two millimeters of the normal contralateral fingertip, with adequate pad for pain-free pinch. We advocate this procedure for deep pulp loss over the distal phalanx. It is reliable, single-staged, and provides skin coverage closer to normal than any regional flap technique.