Cross finger flap cover for fingertip injuries

Srinivasan Rajappa, Tarun Prashanth


Background: Fingertip injuries are the most common form of hand injuries. Restoration of the anatomy is a technical challenge and is one of the basic tenets of the management of fingertip injuries. The cross finger flap is simple and easy to do and is a very useful tool in reconstruction of the pulp of the finger. The project aimed to study the efficacy of cross finger flap in the coverage of fingertip injuries.

Methods: The study was conducted on a prospective basis in Sri Ramachandra University Hospital in Chennai. The study period was from May 2013 to August 2016.  All adults who had fingertip injuries who had undergone cross finger flap cover were included in the study. Patients who had other flaps for reconstruction and who were lost for follow-up were excluded from the study. Preoperative parameters which were recorded were mechanism of injury, size of defect, size of the flap, location of donor site and method of coverage of secondary defect. Outcome measures recorded were flap viability, flap sensibility using two-point discrimination, range of motion of fingers, grip strength and presence of other complications.

Results: 40 patients were included in the study. Six were lost for follow-up. Mean follow-up was 14 months.  All flaps survived. Full range of motion was obtained in 87% of patients. Average grip strength was 94% for dominant hand injuries and 78% for non-dominant hand injuries. Mean quick DASH score was 10.5. Mean two-point discrimination was 15.4 mm.

Conclusions: Cross finger flap is very effective for coverage of volar fingertip defects with minimal residual problems.


Cross finger flap, Fingertip, Two point discrimination

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