Limits and indications of the dorsal transposition flap: Critical evaluation of 15 cases

The dorsal transposition flap was used in 15 cases of distal fingertip amputation. The amputations were either oblique ulnar, oblique radial, oblique palmar, or transverse. Two flaps developed partial necrosis. Flat nail growth always occurred, but the nail was considered short in 4 cases due to a proximal amputation through the nail bed. The mean 2-point discrimination test result was 8 mm. Distal interphalangeal joint range of motion was normal in 5 cases. Four cases lacked 10° from full extension, 9 cases lacked up to 20° from full flexion, and 1 case lacked 35°. Even if this procedure is simple, reliable, and fast, due to its limited size and arc of rotation, as well as its poor sensibility, this flap may only be indicated for oblique ulnar fingertip amputations. (J Hand Surg 2001;26A:277-282. Copyright © 2001 by the American Society for Surgery of the Hand.)