Functional Outcomes and Complications Following Cross-finger Flap Reconstruction for Fingertip Injuries: A Prospective Study

Abstract

Background: Fingertip injuries with exposed bone or soft-tissue loss may require flap reconstruction to preserve finger length, sensibility, mobility and function. The cross-finger flap remains a commonly used local reconstructive option for selected fingertip defects. Methods: This prospective study evaluated patients who underwent cross-finger flap reconstruction for fingertip injuries between May 2022 and January 2026. Fifty-four patients with a minimum follow-up of six months were included. Follow-up ranged from 6 to 34 months, with a mean of 12.4 months. Outcomes assessed included range of motion, two-point discrimination, Quick Disabilities of the Arm, Shoulder and Hand (DASH) score, flap-related complications, donor-site morbidity and return to work. Results: The mean defect size after debridement was 1.95 cm². The mean range of motion of the reconstructed and donor fingers was 89% and 97%, respectively, compared with the corresponding contralateral digits. Mean two-point discrimination was 8 mm, and the mean QuickDASH score was 11.69. Two patients developed limited flap-edge necrosis, which healed with continued dressings, and one patient developed an infection at the donor-finger skin-graft site. No patient reported pain attributable to neuroma formation. All patients resumed their pre-injury work, with a mean reported loss of 28.9 working days. Conclusion: Cross-finger flap reconstruction provided satisfactory functional outcomes in this patient series. Nevertheless, donor-site morbidity and flap-related complications should be considered during patient selection, surgical planning and postoperative rehabilitation.