Background
Treatment options for fingertip amputation distal to flexor digitorm profundus (FDP) insertion include toe pulp transfer, microsurgical replantation, and nonmicrosurgical cap-plasty reattachment. Microsurgical replantation is costly and often fails because of poor venous drainage.
Patients and methods
We reported the results of 12 patients (eight male patients and four female patients) who underwent fingertip reattachment. All patients had type 4 fingertip injury according to Allen's classification. The mean age was 19.5 years. Cap-plasty technique was used for fingertip reattachment in which the amputated tip is sutured back primarily as a composite graft after a thorough debridement with minimal defatting.
Objective
The aim of this study was to evaluate the results of cap-plasty technique in the management of unreplantable fingertip injuries.
Results
All reattachments were successful, with small areas of tip necrosis in three fingers (healing occurred by secondary re-epithelialization) and infection in one patient. The mean static twopoint discrimination was 5.8 mm and pulp pinch was 75% of normal. The mean shortening in the finger length was 3.33 mm.
Conclusion
The cap technique of nonmicrosurgical reattachment is a simple and reliable method of functional preservation of pulp tissue, as well as normal appearance of the nail complex.