If there is enough nail bed left in the fingertip and finger ventral defect, the finger ventral should be reconstructed. The goal of reconstruction is to restore the shape of the finger ventral, and the reconstructed finger ventral should be wear-resistant, elastic, sensitive, without damaging important vascular nerves, and easy to operate. 1. Anatomical basis of spiral flap The intrinsic neurovascular bundle of the finger is constant on both sides of the palmar flexor tendon sheath, gradually thinning distally, along which many branches are issued, with different degrees of anastomosis between each branch, supplying the dorsal and palmar skin of the finger. The blood supply and venous return of the flap are physiological circulation, and the flap is easy to be viable. 2. Advantages and disadvantages of this procedure The spiral flap with the intrinsic neurovascular bundle on one side of the same finger was used to reconstruct the ventral defect, which is in accordance with the principle of taking the material nearby and has the following advantages: (1) the flap is a prograde flap with physiological circulation, and the flap is easy to be revived because of the 3 cm pushing distance. ②The flap contains the intrinsic nerve of the finger, so there is no need for nerve anastomosis, and the reconstructed finger can recover sensation quickly and tolerate cold, and the average of two points of discrimination in this group is 5.1 mm. ③Postoperative braking is not required, and active functional exercise of the finger can be performed at an early stage without causing ankylosis of the interphalangeal joint. ④The reconstructed finger has a full belly and good shape, and the palmar dermatoglyphs match with the original residual fingerprints. ⑤The operation is simple and easy, and can be completed at one time. Disadvantages: ①This flap cannot reconstruct the nail bed, and if there is apical defect repaired with this flap, the nail shape will change later to form a bird’s beak-like nail, which happened in four cases in this group, probably because the nail bed lost proper bony and soft tissue support, and the end of the nail bed was pulled by the palmar flap when the end interphalangeal joint was straightened. The scar left at the dorsal surface of the middle phalangeal implant has a certain impact on the aesthetics. 3.Surgical precautions ①Check carefully before operation and perform Allen’s test. (2) When dissecting the neurovascular bundle, bring 3mm fascial tip to facilitate venous reflux, and if the pushing distance is large, dissect the neurovascular bundle proximally to reach the common finger artery. (iii) Pay attention to protect the intrinsic nerve vessels on the other side of the finger. ④ Lift the flap on the superficial surface of the perimembranous membrane of the extensor tendon and the superficial layer of the flexor tendon. (⑤When wrapping, the finger is slightly flexed to avoid excessive tension on the neurovascular bundle in the extended position.