Fingertip defect reconstruction with a modified pivot flap.

The pivot flap can treat volar oblique defects of the fingers distal to the distal interphalangeal joint. We present our experience in 11 fingers (11 patients) using this flap, including some modifications that optimize flap harvesting, mobilization, inset, and vascular supply and outcomes. The flaps harvested had an average size of 2.4 × 2.0 cm. The patients were followed for an average of 21 months (range 12 to 36) after surgery. Sensitivity of the flap was evaluated with the Semmes-Weinstein monofilaments test and static two-point discrimination test. Cold intolerance was also evaluated. The pivot flap with the modifications demonstrates a reliable technique for fingertip defect reconstruction. The results, in terms of sensitivity and functional recovery, seem promising. Level of evidence: IV.