TechniquesVolar Neurovascular Advancement Flap With an All Neural Branch–preserving TechniqueLiu, Wen-Chih MD*,†; Wen, Chaoxi MD‡; Wang, Zengtao MD‡Author Information *Division of Orthopedic Surgery, Kaohsiung Municipal Siaogang Hospital †Department Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan ‡Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinana, China W.-C.L. and C.W. contribute equally. The patients agreed to the publication of their surgical images. Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Zengtao Wang, MD, Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No. 324, Jingwu Road, Jinan 250021, Shandong, China. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: June 2021 - Volume 25 - Issue 2 - p 63-68 doi: 10.1097/BTH.0000000000000306 Buy Metrics Abstract Several fingertip reconstruction options exist, among which, the use of a volar advancement flap or local transposition flap is a simple and effective technique for reconstructing the volar pulp with the same skin texture. To advance the flap, we have to release the tethering structure and sometimes include the neural branches. We describe a concept of an all neural branch–preserving technique to harvest a volar flap. We demonstrate this technique on an anatomic specimen and 1 case with delicate surgical tips. We performed this technique in 16 patients, and the mean follow-up period was 28.4 months. The mean range of motion of the distal interphalangeal joint was 70.3 degrees, and that of the proximal interphalangeal joint was 101.9 degrees. The mean static 2-point discrimination of the volar pulp was 4.8 mm. This technique could be applied on the volar advancement flap with a better sensation recovery. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.