A distal dorsal island homodigital flap has been used for reconstruction of fingertips in nine patients who sustained traumatic amputations either obliquely or transversely through the middle of the distal phalanx. Seven of the nine patients attended for follow-up. All the flaps survived with the exception of a small area of partial necrosis in one patient. Fingertip reconstruction with this flap is a one-stage procedure, safe, easy to perform and provides durable tissue support for the nail to regrow undeformed.