Reconstruction of Distal Amputation of the Right Index Finger Using a Kutler Flap: A Case Report

Abstract

Traumatic fingertip injuries are common in clinical practice and represent a reconstructive challenge due to the need to preserve digital length, sensation, and hand function. Among the various therapeutic options available, the bilateral Kutler V-Y advancement flap is an effective alternative for the reconstruction of small to medium-sized distal defects with limited bone exposure. We present the case of a 34-year-old male patient with a traumatic distal amputation of the right index finger secondary to a workplace accident, resulting in pulp soft tissue loss and exposure of the distal phalanx. Following clinical and radiographic evaluation, reconstruction using a bilateral Kutler V-Y advancement flap was performed. The procedure consisted of debridement of devitalized tissue, design of two lateral triangular flaps based on the digital neurovascular bundles, elevation and distal advancement of the flaps to achieve complete defect coverage, followed by tension-free primary closure. Postoperative recovery was favorable, with no evidence of infection, necrosis, or wound dehiscence. Adequate defect coverage, preservation of digital length, maintained protective sensation, and satisfactory functional recovery were achieved, allowing the patient to return to normal daily activities. The bilateral Kutler V-Y advancement flap remains a reliable, technically straightforward, and low-morbidity reconstructive option that provides favorable functional and aesthetic outcomes in the treatment of traumatic fingertip injuries with limited bone exposure.