Allen type IV fingertip amputations were treated by a modified technique, when the replantation is difficult to be performed or not an option. The pre-existing technique involves nail bed grafting and local flap. In the modified technique, a free bone graft is added, bone and free nail bed repositioned and pulp reconstruction by local flap. This can be best described "graft reposition on flap" (GRF). GRF was found to be simple and cost effective. It allows preservation of finger length and a fully functional and cosmetically acceptable nail.
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