The “Extreme Atasoy” flap

Background Distal finger injuries are very common in Hand Surgery. The purpose of this paper is to describe our “Extreme Atasoy flap” technique in the reconstruction of apical lesions of the fingers. Methods Twenty patients were treated with the “Extreme Atasoy flap” technique. The following variables were evaluated: age, sex, comorbidity, cause of amputation, Visual Analogue Scale for pain assessment to time 0 (VAS T0), VAS to time 30 days (VAS T30), hospitalization time (HT), time to heal (TH), major complications (MC), minor complications (mC), advancement flap (AF), and static 2-point discrimination test to assess sensitivity. Results In our case series, no major complications were present. The average healing time was 2.4 days, and the 2-point discrimination test regarding sensitivity was satisfactory. The patients reported good aesthetic and functional outcomes. Conclusions Treatment of fingertip injuries is an important topic in Hand Surgery. Local flaps are common forms of treatment in these kinds of injuries. The surgical technique is similar to that described by Atasoy, but with some important differences: the preoperative design is different, the donor site is not closed with stitches but heals by secondary intention, and the vascular pedicles are extremely skeletonized. This technique has proven to be safe and simple to carry out and provides good coverage of the distal portions of the fingers. Level of Evidence: Level V, therapeutic study