The “cap” technique: Nonmicrosurgical reattachment of fingertip amputations

Elliott H. Rose, Michael S. Norris, Thomas A. Kowalski, Armand Lucas, Earl J. Fleegler

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


With the exception of children, amputations at the level of the lunula survive poorly by direct reattachment. Microsurgical replantation is costly and often fails because of poor venous drainage. In a series of seven adult patients the severed tip was filleted and replaced as a “cap” over the skeletonized distal phalanx of the stump. A 2 mm remnant of germinal matrix was preserved for nail regrowth. The reconstructed digits, although shortened by an average of 6 mm, give the “illusion” of a normal finger. All were successful with small areas of tip necrosis in two, healing by secondary reepithelialization. Mean static two-point discrimination was 6.5 mm (range, 3 to 10 mm) and pulp pinch was 67% of normal. The “cap” technique of nonmicrosurgical reattachment is a simple, reliable method of functional preservation of pulp tissue, as well as normal esthetic appearance of the nail complex.

Original languageEnglish
Pages (from-to)513-518
Number of pages6
JournalJournal of Hand Surgery
Issue number3
StatePublished - 1989


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