The "clover FLAP": A one-stage local flap for dorsal fingertip and nail bed reconstruction.

Cohort studyJournal of hand and microsurgery· Nov 2025

The "clover FLAP": A one-stage local flap for dorsal fingertip and nail bed reconstruction.

Pier Paolo Pangrazi, Francesco De Francesco, Michele Riccio

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Hand & Peripheral NerveCohort studyQ3IF 0.8

Clover flap gave low nail deformity rates in dorsal fingertip reconstruction

The "clover FLAP": A one-stage local flap for dorsal fingertip and nail bed reconstruction.

Pier Paolo Pangrazi … Michele Riccio

Journal of hand and microsurgery · Nov 2025 · Q3 in Surgery

Background

Fingertip and nail bed injuries represent complex reconstructive challenges in hand surgery, requiring restoration of both function and aesthetics.

Purpose

This study presents and evaluates the "clover flap," a novel homodigital advancement technique designed for dorsal fingertip injuries involving partial or complete nail bed loss.

Methods

In this retrospective cohort study, 63 patients with dorsal fingertip defects were treated between 2005 and 2023 using the clover flap at a primary referral center.

n = 63 patients

17.5%

Results

17.5%

nail deformity was uncommon after clover flap reconstruction

n = 63 patients

More results

No complete flap necrosis occurred.

Patients achieved a mean Quick-DASH score of 14.6, 2PD of 7.3 mm, and an active ROM of 224°.

Grip and pinch strength recovered to 79 % and 81 % of the contralateral side, respectively.

Aesthetic outcomes were favorable, with an OFNAS of 4.5 and FIOS of 11.3.

“

Conclusion · 1 of 2

The clover flap offers a reliable, one-stage reconstructive option for dorsal fingertip injuries, combining high functional recovery with excellent nail bed and scar aesthetics.

Conclusion · 2 of 2

Its design preserves nail matrix integrity, avoids microsurgery, and is particularly suitable in acute care settings.

The "clover FLAP": A one-stage local flap for dorsal fingertip and nail bed reconstruction.

The "clover FLAP": A one-stage local flap for dorsal fingertip and nail bed reconstruction.

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