Abstract
Objectives: The most common amputations to the hand are fingertip injuries. It may be difficult to restore fingertip both functionally and cosmetically in these injuries. In our study, we aimed to evaluate the functional outcomes of patients who underwent antegrade homodigital neurovascular island flap (AHNIF).
Methods: Between January 2020 and September 2022, a retrospective analysis was performed on 12 patients who underwent AHNIF due to fingertip injuries. The demographics of the patients, mechanisms of injury, defect sizes, and follow-up durations were documented. Amputation levels were defined. Flap sensitivity was assessed using the static 2-point discrimination test. Range of motion and contractures of the proximal interphalangeal and distal interphalangeal joints were measured. Cold intolerance was evaluated with the Cold Intolerance Symptom Severity (CISS) score. Patient's aesthetic satisfaction was evaluated with the Aesthetic Numeric Analog score.
Results: The mean age of the patients was 40.91 years, with a mean follow-up duration of 14.41 months. The mean range of motion for the distal interphalangeal (DIP) joint was 81.6°, and for the proximal interphalangeal (PIP) joint was 92.5°. Flexion contracture was present in five patients, with a mean contracture degree of 6. The mean CISS score for the patients was 4.41, and the Aesthetic Numeric Analog score was 6.33. The mean 2-point discrimination was 5.41 mm.
Conclusion: AHNIF is one of the effective methods to restore fingertip function after amputations that cause significant tissue loss. It provides predictable and satisfactory outcomes in terms of flap survival, pulp sensitivity, and mobile adjacent joints.

Key words: Antegrad homodigital flap, digital artery island flap, fingertip reconstruction, neurovascular flap