Objective: To investigate the clinical value of double V-Y flap combined with nail lengthening in the treatment of partial defects of fingers and nail bed, and compare the differences between it and traditional non-combined surgery in fingertip functional reconstruction, cosmetic repair, and prognosis. Methods: Sixty-two patients with partial defects of fingers and nail bed admitted to our hospital from January 2025 to July 2025 were selected as the research objects and were divided into control group (n=31, repaired with conventional free flap or single V-Y flap) and observation group (n=31, performed with double V-Y flap combined with nail lengthening). Follow-up was performed for 6 months, and the wound healing time, nail shape parameters, sensory recovery, hand function scores, peripheral circulation indicators and complication rates were compared between the two groups. Results: The wound healing time in the observation group was shorter than that in the control group (P<0.05), the two-point discrimination was smaller than that in the control group (P<0.05), and the postoperative nail length, nail curvature score, local tissue oxygen partial pressure, and peripheral blood perfusion volume were higher than those in the control group (P<0.05). In terms of hand function assessment, the scores of overall hand function, daily living ability, work performance, appearance, and functional satisfaction in the observation group were higher than those in the control group (P<0.05), and the pain score was lower (P<0.05). The overall incidence of complications in the observation group was lower (P<0.05). Conclusion: Double V-Y flap combined with nail lengthening can effectively shorten the wound healing cycle of patients with fingertip defects, better reconstruct the sensory function of the fingertips and the appearance of the nails, improve the overall function of the affected fingers and patient satisfaction after surgery, and is safer.