The Atasoy, or Kleinert flap, is well-known to hand surgeons. This triangular volar V-Y flap is frequently used for reconstruction of fingertip amputations with exposed bone. It is indicated in transverse amputations or in dorsal oblique amputations, providing replacement of an area of skin and subcutaneous tissues with sensibility. Originally, this flap was not recommended for use in volar oblique amputations (greater volar tissue loss). With the described modifications and recommendations, modest volar oblique amputations can be closed in a single stage, obviating a 2-stage procedure.
With the described technical modifications, modest volar oblique amputations can be closed. An injury that previously may have required a 2-stage procedure can be closed in a single stage.
The elevation of the flap was originally described as a dissection at the volar periosteum from a distal approach. This distal dissection is no longer recommended, as it does not create advancement. Beasley indicated the need for division of the vertical fibrous septa proximally for flap mobilization. This technique description emphasizes the importance of this division of the fibrous septa rather than stretching. Careful treatment of the remaining bone is stressed. Coverage of the nail bed is not recommended.
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From the *Division of Plastic, Reconstructive and Aesthetic Surgery
†Division of Plastic, Reconstructive and Aesthetic Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Fla.
Published online 5 December 2018.
Received for publication April 18, 2018; accepted October 12, 2018.
Disclosure:The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by Dr. Viciana himself.
Anne-Sophie Lessard, MD, Division of Plastic, Reconstructive and Aesthetic Surgery, University of Miami Leonard M. Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, E-mail: email@example.com