V-Y Advancement flap - for Fingertip amputations

VY advancement flap, namely Kutler flap and Atasoy flap, has proven their worth for fingertip reconstruction over time

1. V-Y Advancement Flaps

2. One of the workhorse flaps used to resurface fingertip amputations. Content- Skin Subcutaneous tissue above periosteum and flexor tendon sheath

3. Indications:- 1) Best used for resurfacing of fingertip amputation that is transverse or volar favourable. 2) At least 15 mm of the distal segment of the finger (measured from the distal interphalangeal joint crease) should be available for flap advancement.

4. Volar VY advancement – Atasoy -Kleinert Flap Bilateral Lateral VY advancement – Kutler Flap

5. Surgical Anatomy:- Supplied by- by the terminal branches of the digital artery ie anastomotic connections between the terminal branches of the volar digital arteries and the dorsal arches through the fibro-osseous hiatus branch. In Atasaoy (single midline) Skin and fibrous attachments incised – Terminal branches of digital artery and nerve preserved.

6. [1] [2]

7. Operative Technique:-

8. References:- A COMPARATIVE STUDY OF THE SUPRAPERIOSTEAL AND THE SUBPERIOSTEAL DISSECTION IN THE V-Y ADVANCEMENT (ATASOY) FLAP FOR THE MANAGEMENT OF FINGERTIP INJURY - Scientific Figure on ResearchGate. Available from: https:// www.researchgate.net /figure/The-blood-supply-of-the-finger-tip_fig1_309847871 [accessed 9 Mar, 2024] Authors: Agur , Anne M.R.; Dalley , Arthur F. Title: Grant's Atlas of Anatomy, 12th EditionCopyright ©2009 Lippincott Williams & Wilkins . VY Advancement, Thenar Flap, and Cross-finger Flaps ; Jin Xi Lim, MBBSa,b ,*, Kevin C. Chung, MD, MSc VY Advancement, Thenar Flap, and Cross-finger Flaps Hand Clin 36 (2020) 19–32https:// doi.org /10.1016/ j.hcl.2019.08.0030749 -0712/20/! 2019 Elsevier Inc . Reconstructive Surgery- Principles, Anatomy and Technique- Mathes and Nahai-Volume 1- GREEN’S OPERATIVE HAND SURGERY, EIGHTH EDITIONCopyright © 2022 by Elsevier, Inc. All rights reserved.ISBN: 978-0-323-69793-4 Volume 1 ISBN: 978-0-323-83397-4 Volume 2 ISBN: 978-0-323-83398-1 Flaps and Reconstructive Surgery – Fu Chan Wei ; Samir Mardini - second edition – Elsevier Inc.