著者

大中 敬子 普天間 朝上 米田 晋 西田 康太郎

出版者

日本マイクロサージャリー学会

雑誌

日本マイクロサージャリー学会会誌 (ISSN:09164936)

巻号頁・発行日

vol.34, no.3, pp.167-171, 2021

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<p> The graft on flap method is useful for fresh fingertip amputation. We report a case in which the composite graft method was used after injury and the graft on flap method was used for cutaneous graft necrosis on day 12. A 48-year-old woman sustained complete amputation of her little finger after getting her hand caught in a machine at work. The injury was crush type and the amputation level was subzone II (Ishikawa's classification) . The osteo-cutaneous composite graft method was applied 2 and a half hours after injury. As cutaneous graft necrosis observed on day 12, the graft on flap method was performed on the same day. The defect lesion was covered with a volar V-Y advanced flap after the distal phalanx fragment was fixed. The flap survived and union of the distal phalanx fracture was achieved 2 months after surgery. The nail grew 3 months after surgery. Seven months after surgery, she had neither numbness nor pain, and had no difficulties. The graft on flap method may be effective in cases where bone and nail bed grafts survive even if the operation is delayed.</p>