Restoration of the Injured Fingertip with Eponychial Cutaneous Flap

손톱위 피부피판을 이용한 손톱형태 복원의 치험례

  • Kim, Ho Kil (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Cheol Hann (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kang, Sang Gyu (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Jung, Sung Gyun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Yong Bae (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 김호길 (순천향대학교 의과대학 성형외과학교실) ;
  • 김철한 (순천향대학교 의과대학 성형외과학교실) ;
  • 강상규 (순천향대학교 의과대학 성형외과학교실) ;
  • 정성균 (순천향대학교 의과대학 성형외과학교실) ;
  • 김용배 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2005.06.27
  • Published : 2005.11.10

Abstract

The restoration of the fingernail is not simple in case of amputated distal fingertip which involved the pulp and nail. The nail should maintain a length of at least 2 mm from the eponychium for an adequate grip and decent appearance. Various methods to reconstruct the fingernail bed are available. The nail bed graft from amputated finger or great toe, and free onychocutaneous flap are commonly used. The nail bed of the injured tip tends to be atrophied, deformed and failed as a graft. And the great toe is often turned down as a donor. We have restored satisfactorily the nail beds of three injured finger tips with eponychial cutaneous flaps. The pulps were reconstructed with either a reverse dorsal digital island flap or free pulp graft. Repeated again. A mean follow- up was six months. The nail grew up to the average of 3.7 mm. All patients were satisfied with the length of the nail and met with good cosmetic results. An eponychial cutaneous flap is useful to restore the nail of the distal fingertip amputation. The procedure is relatively simple and morbidity is minimum.

Keywords

References

  1. Sommer NZ, Brown RE: The perionychium. In Green DP, Hotchkiss RN, Pederson WC, Wolfe SW(eds): Green's Operative Hand Surgery. 15th ed, Philadelphia, Churchill Livingstone, 2005, p 389
  2. Lim JH, Kim TY, Chung CE: Nailplasty utilizing S.T.S.G in subeponichial pocket and insertion of a prosthetic nail. J Korea Soc Plast Reconstr Surg 17: 1127, 1990
  3. Pessa JE, Tsai TM, Li Y, Kleinert HE: The repair of nail deformities with the nonvascularized nail bed graft: Indications and results. J Hand Surg 15: 466, 1990 https://doi.org/10.1016/0363-5023(90)90062-V
  4. Shepard GH: Nail grafts for reconstruction. Hand Clin 6: 79, 1990
  5. Koshima I, Moriguchi T, Soeda S, Ishii M, Murashita T: Free thin osteo-onychocutaneous flaps from the big toe for reconstruction of the distal phalanx of the fingers. Br J Plast Surg 45: 1, 1992
  6. Nakayama Y, Iino T, Uchida A, Kiyosawa T, Soeda S: Vascularized free nail grafts nourished by arterial inflow from the venous system. Plast Reconstr Surg 85: 239, 1990 https://doi.org/10.1097/00006534-199002000-00012
  7. Adani R, Marcoccio I, Tarallo L: Nail lengthening and fingertip amputation. Plast Reconstr Surg 112: 1287, 2003 https://doi.org/10.1097/01.PRS.0000081463.70948.70
  8. Zook EG, Van Beek AL, Russell RC, Beatty ME: Anatomy and physiology of the perionychium: A review of the literature and anatomic study. J Hand Surg 5: 528, 1980