Delayed Extended “Midthenar” Flap for Reconstruction of Total Fingertip Avulsion Injury and a Proposal of Ideal Postoperative Immobilization for a Palmar FlapSano, Kazufumi MD, PhD; Aoki, Shinpo MD; Koike, Sachiko MD; Hyakusoku, Hiko MD, PhDAnnals of Plastic Surgery: January 2007 - Volume 58 - Issue 1 - p 116-119 doi: 10.1097/01.sap.0000232982.12014.35 Tips and Techniques Buy Abstract Author InformationAuthors Article MetricsMetrics Avulsion injury through the base of the distal phalanx of the ring finger with a large projecting tip of exposed bone was treated with delayed extended midthenar flap. The midthenar flap adding delay procedure at the first stage of a consecutive 2-stage operation could provide extended flap length to wrap the large projecting tip of the exposed bone at the second stage. This flap is useful for the middle and ring fingertip injury because motions of the all thumb joints are not restricted during the immobilization period. To reduce immobilization discomfort between the 2 stages of the palmar flap operation, a “relaxed flexion position” immobilization technique devised by the authors is also introduced. From the Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo, Japan. Received April 23, 2006, and accepted for publication, after revision, May 30, 2006. Reprints: Kazufumi Sano, MD, Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi Bunkyo-ku Tokyo, 113-8603, Japan. E-mail: email@example.com. © 2007 Lippincott Williams & Wilkins, Inc.