Figure 1.

(Above, left) Eleven-year-old boy with traumatic amputation of the right middle fingertip in a bicycle accident. (Above, center) Composite loss of skin, pulp, and nail support. (Above, right) Design of laterally based thenar flap with distal border at MP flexion crease and w-plasty at the tip. (Below, left) Flap inset, at the time of division. (Below, center) Result at 3 years postoperatively, volar view. (Below, right) Result at 3 years postoperatively, lateral view, at full extension.