Reconstruction of damaged fingernail with transplantation of the autologous big toenail flap and its clinical efficacy evaluation
Objective To evaluate the clinical therapeutical efficacy of the reconstruction and reparation of damaged fingernail by transplanting the autologous big toenail flap.Methods A retrospective analysis of the selected 15 patients in our hospital suffered from fingernail and soft tissue defects between May 2021 and May 2022 was performed.The damaged fingernail was repaired and reconstructed via the transplantation of autogenous vascularized big toenail flap based on the size of fingernail defect and big toenail.The clinical efficacy was estimated according to the evaluation standard for thumb and finger reconstruction founded by International Federation of Society for Surgery of the Hand and Society of Hand Surgery of Chinese Medical Association.Results All transplanted fingernails and nailflaps of 15 patients survived.Vascular crisis appeared on one patient at 24 h after surgery;however,the vascular crisis was restored after blood vessel grafts and re-anastomosis.The mobility of the distal interphalangeal joints of all patients almost returned to normal,and the repaired fingernail grew normally.The walking function of the foot in the donor area was not significantly influenced,displaying a normal gait;the patients can walk with a load without the formation of plantar ulcer.After 3-12 months'follow-up,12 cases were comprehensively graded as excellent and 3 cases graded as good.According to the EG ZooK(1984)evaluation standard of nail recovery,the good rate reached as high as 87.5%.All patients were satisfied with the postoperative results.Conclusions Reconstructing damaged fingernails via the transplantation of autologous vascularized toenail flap has been certified to be effective in repairing fingernail defects and damaged nerve,thereby facilitating the recovery of finger appearance and function.
NailsWounds and injuriesFree tissue flapsMicrosurgery
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