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. 2019 Jul 4;9:9720. doi: 10.1038/s41598-019-45521-4

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Proposed model for differential tissue repair after digit tip amputation. Distal amputations preserve the Wnt activation zone (pink) and bone progenitor periosteal cells (darkest blue), which are important for distal appositional bone growth during development and after distal amputation (a, a’). Proximal amputation removes the Wnt activation zone and the periosteum of the digit tip (b). Without Wnt activation and periosteum, no distal appositional bone regrowth is expected to occur. If present, these structures will promote distal appositional bone regrowth, nail bed extension; leading to the close to normal morphology observed in distally amputated digits.