• Feng Ni, Sarah E Appleton, Bo Chen, and Bin Wang.
• Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
• J Hand Surg Am. 2012 Sep 1;37(9):1806-11.

PurposeSensate reconstruction with glabrous skin is essential for ideal resurfacing of fingertip and pulp defects. The purpose of this study was to examine the palmar pivot flap as a reconstructive option for fingertip and pulp defects.MethodsWe used the palmar pivot flap to repair fingertip and pulp defects in 21 consecutive patients. Outcomes measured included range of motion of the distal interphalangeal and proximal interphalangeal joints, sensation, pain, cold intolerance, and percussion tenderness. We assessed patient satisfaction with the aesthetic outcome using the Michigan Hand Outcomes Questionnaire.ResultsAll flaps survived. We achieved complete mobility at the distal interphalangeal and proximal interphalangeal joints. Sensory recovery was demonstrated in all flaps within 2 weeks postoperatively. No painful tips were reported at an average follow-up of 11 months. All flaps had mild cold intolerance, and 1 patient reported mild percussion tenderness. All patients were satisfied with the appearance of the reconstructed fingertips.ConclusionsThe palmar pivot flap can provide sensate glabrous skin for the effective reconstruction of fingertip and pulp defects, resulting in aesthetically pleasing and good functional outcomes.Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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