Progressive subcutaneous pedicle double V-Y flap combined with iliac bone graft for the treatment of hook nail deformity after finger trauma in children
Objective To explore the clinical efficacy of progressive subcutaneous pedicle double V-Y flap combined with iliac bone graft for the treatment of mild to moderate hook nail deformity after finger trauma surgery in children.Methods From June 2019 to June 2022,7 children with hook nail deformities after finger trauma surgery were treated by a progressive subcutaneous pedicle double V-Y advancement flap combined with iliac bone graft.The corrected finger length and appearance after surgery were followed up and observed,the grading of fingertip sensation was assessed,single filament tactile and two-point discrimination were measured,and the condition of finger abdominal scar was evaluated using the Vancouver scar scale(VSS).Results All 7 flaps survived after surgery,without any infection,flap necrosis,or bone exposure.The bone healing time was 4 to 5 weeks,with an average of 4.2 weeks.The postoperative follow-up time was 10 to 35 months,with an average of 19.1 months.At the last follow-up,the skin flap had good color and texture,and after reconstruction,the shape of the fingertip was satisfactory.The interphalangeal joint activity was normal,and no hook nail deformity occurred.The preoperative finger defect was 3 to 8 mm,and during the last follow-up,the affected finger defect was 1 to 4 mm.The sensory rating was S4,with a single filament tactile sensation of 2.83 to 3.61,a two-point discrimination of 5 to 8 mm,and a VSS of 2 to 4.Conclusion The application of progressive subcutaneous pedicle double V-Y flap combined with iliac bone graft for the treatment of mild to moderate hook nail deformity after finger trauma surgery in children can effectively improve finger length and nail appearance.The surgical operation is simple,the clinical efficacy is accurate,and it is easy to promote at the grassroots level.
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