Extended step-advancement flap for avulsed amputated fingertip--a new technique to preserve finger length: case series.

Purpose: The conventional step-advancement flap does not restore fingertip length after avulsion amputation with projecting bone owing to the limited size of the distal triangular flap. To overcome this problem, the extended step advancement flap using the stepladder principle, described in this article, provides an extended distal triangular flap that can be wrapped around the projecting tip of the distal phalanx while avoiding longitudinal volar scarring. The purposes of this study were to present a modification of the original step-advancement technique and to report on results in 6 patients.