Redesigned V-Y Flap for the Reconstruction of Fassler Type D Fingertip Injuries: A Case Report and Literature Review

Background: Fassler Type D fingertip injuries represent a significant reconstructive challenge as they involve bone exposure and compromise of the nail complex. The redesigned V-Y flap offers a simple, safe, and functional alternative for small to moderate defects, providing low morbidity and preserving length, sensitivity, and aesthetics. Objective: To present a clinical case reconstructed using a redesigned V-Y flap and a nail splint, highlighting the technique, clinical outcomes, and contemporary applicability. Methods: We described the case of a 35-year-old male with a Fassler D-Type fingertip injury to the fourth finger. The defect measured 10 mm x 0.8 mm with distal phalanx bone exposure. An andvancing V-Y flap was performed, modifying the incision with an oblique cut being preferred, and subsequent release of the septa to maximize tension-free displacement. A synthetic nail splint was made with polypropylene and fixed with sutures. Results: Complete coverage and restoration of tissue continuity were achieved under local anesthesia. Follow-up at 4 weeks demonstrated preservation of digital length and sensory recovery with two-point discrimination, restoring both aesthetics and functionality of the fingertip. Conclusions: The redesigned V-Y flap is a reliable and reproducible option for distal reconstructions with bone exposure, particularly in resource-limited settings.