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Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting 원문보기

Archives of plastic surgery : APS, v.46 no.1, 2019년, pp.57 - 62  

Lee, Kyung Jin (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ,  Kim, Yong Woo (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ,  Kim, Jin Soo (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ,  Roh, Si Young (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital) ,  Lee, Dong Chul (Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital)

Abstract ▼ AI-Helper 아이콘AI-Helper

Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were ...

주제어

#Finger injuries   #Nails   #Fascia   #Reconstructive surgical procedures   #Surgical flaps  

AI 본문요약
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제안 방법

  • The procedure can be performed under regional or general anesthesia. All patients included in the study had full-thickness nail bed defects with distal phalanx exposure, with a defect size that exceeded half the size of the sterile matrix (Fig. 1A). We designed a proximally based skin flap on the thenar eminence [1], and made an H- or U-shaped skin incision.
  • Between May 2014 and August 2016, we selected patients who presented to our department with a full-thickness nail bed defect and significant exposure of the distal phalanx. All patients were treated via a 2-stage surgical procedure that involved first covering the exposed distal phalanx with a thenar fascial flap, followed by 2 weeks of immobilization and then flap division with nail bed grafting. Because this procedure is suitable for treating injuries to the index, middle, and ring fingers, we excluded patients with injuries to the thumb or little finger.
  • Nail growth was evaluated by retrospective review of the clinical charts and photographs taken during follow-up. At the final follow-up, the nails were evaluated by comparing them with the corresponding contralateral nails.

대상 데이터

  • Nine patients (age range, 25–72 years; mean age, 44 years; 7 males and 2 females; 9 fingers) were evaluated at follow-up examinations.
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참고문헌 (18)

  1. 1 Dellon AL The proximal inset thenar flap for fingertip reconstruction Plast Reconstr Surg 1983 72 698 704 6622576 

    상세보기

  2. 2 Flatt AE The thenar flap J Bone Joint Surg Br 1957 39-B 80 5 13405949 

  3. 3 Sommer NZ Perionychium Wolfe SW Hotchkiss RN Pederson WC Green’s operative hand surgery 7th ed Philadelphia Elsevier 2016 318 37 

  4. 4 Zook EG Guy RJ Russell RC A study of nail bed injuries: causes, treatment, and prognosis J Hand Surg Am 1984 9 247 52 6715836 

  5. 5 Clayburgh RH Wood MB Cooney WP 3rd Nail bed repair and reconstruction by reverse dermal grafts J Hand Surg Am 1983 8(5 Pt 1) 594 8 6630937 

  6. 6 Sheehan JE Replacement of thumb nail JAMA 1929 92 1253 5 

  7. 7 Lille S Brown RE Zook EE Free nonvascularized composite nail grafts: an institutional experience Plast Reconstr Surg 2000 105 2412 5 10845295 

    상세보기

  8. 8 Nam SB The perionychium The Korean Society for Surgery of the Hand Surgery of the hand 1st ed Seoul Bumoon Education 2014 155 61 

  9. 9 Endo T Nakayama Y Microtransfers for nail and fingertip replacement Hand Clin 2002 18 615 22 12516976 

    상세보기

  10. 10 Koshima I Inagawa K Urushibara K Fingertip reconstructions using partial-toe transfers Plast Reconstr Surg 2000 105 1666 74 10809096 

    상세보기

  11. 11 Lewis BL Microscopic studies of fetal and mature nail and surrounding soft tissue AMA Arch Derm Syphilol 1954 70 733 47 13206419 

  12. 12 De Berker D Mawhinney B Sviland L Quantification of regional matrix nail production Br J Dermatol 1996 134 1083 6 8763429 

    상세보기

  13. 13 Barron JN The structure and function of the skin of the hand Hand 1970 2 93 6 4938924 

    상세보기

  14. 14 Johnson M Shuster S Continuous formation of nail along the bed Br J Dermatol 1993 128 277 80 8471510 

    상세보기

  15. 15 Lorea P Primary care of nail traumas Chir Main 2013 32 129 35 23706592 

  16. 16 Brown RE Zook EG Russell RC Fingertip reconstruction with flaps and nail bed grafts J Hand Surg Am 1999 24 345 51 10194021 

  17. 17 Shepard GH Treatment of nail bed avulsions with split-thickness nail bed grafts J Hand Surg Am 1983 8 49 54 6827053 

  18. 18 Melone CP Jr Beasley RW Carstens JH Jr The thenar flap: an analysis of its use in 150 cases J Hand Surg Am 1982 7 291 7 7086099 

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