Delayed Extended ???Midthenar??? Flap for Reconstruction of Total Fingertip Avulsion Injury and a Proposal of Ideal Postoperative Immobilization for a Palmar Flap

Avulsion injury through the base of the distal phalanx of the ring finger with a large projecting tip of exposed bone was treated with delayed extended midthenar flap. The midthenar flap adding delay procedure at the first stage of a consecutive 2-stage operation could provide extended flap length to wrap the large projecting tip of the exposed bone at the second stage. This flap is useful for the middle and ring fingertip injury because motions of the all thumb joints are not restricted during the immobilization period. To reduce immobilization discomfort between the 2 stages of the palmar flap operation, a "relaxed flexion position" immobilization technique devised by the authors is also introduced.