Single-Stage Reconstruction of Fingertip Amputation with a Soft Tissue Advancement Flap and Full-Thickness Skin Graft Harvested from the Amputated Segment

Background: Crushed fingertip amputations with exposed bone may be unsuitable for replantation or direct composite grafting despite usable skin retained in the amputated segment. We evaluated a subcutaneous advancement flap combined with full-thickness skin grafts from the amputated segment for preserving specialized fingertip tissue.Methods: We retrospectively reviewed 15 adults with 15 injured fingertips treated between October 2023 and October 2025. Vascularized subcutaneous tissue covered exposed bone, followed by immediate grafting of defatted skin retaining the epidermis and full dermis. Follow-up generally extended to 6–12 months. Wound healing, secondary surgery, and postoperative sensibility were assessed.Results: Mean age was 60.9 years (range, 39–73 years); 13 patients were male. Fourteen patients (93.3%) healed without secondary surgery. One patient (6.7%) underwent stump revision for partial necrosis. No additional flap or graft was required. All wounds ultimately healed without persistent wound problems. Mean postoperative static two-point discrimination was 6.5 mm (range, 4–11 mm).Conclusion: Single-stage subcutaneous advancement with salvaged full-thickness skin grafts provides a tissue-preserving option for selected crushed fingertip amputations. Vascularized bone coverage enables reuse of the original fingertip skin. Comparative benefits require further study.