We retrospectively reviewed the cases of 14 fingertips reconstructed with a
combination of local or regional flaps and nail bed grafts, some of which
were placed wholly or partially over a de-epithelialized flap. Most of the
fingertips sustained a crushing injury and were reconstructed at the time o
f the injury. Soft tissue coverage was provided by palmar V-Y flaps in 6 ca
ses, thenar flaps in 4, lateral V-Y flaps in 2, a Moberg flap in 1, and a c
ross-finger flap in 1. Split toenail bed grafts were used in 6 cases, full-
thickness nail bed grafts from the amputated part in 6, and split nail bed
grafts from the injured digit in 2. There was 1 partial graft loss and 1 pa
rtial flap loss. The remaining cases had completely successful grafts and g
ood soft tissue healing. Subsequent nail growth and adherence were good in
all but the 1 digit requiring secondary composite grafting. Copyright (C) 1
999 by the American Society for Surgery of the Hand.