Onychocutaneous Flap: Fingernail Reconstruction with Arterialized Venous Free Nail Flap

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Journal of the Korean Society for Surgery of the Hand 2005;10(3):142-148.
Published online September 1, 2005.

Gi-Doo Kwon, Byung-Moon Ahn, Sang-Mok Lee, Young-Bum Yo

유리 동맥화 정맥 조갑 피판술을 이용한 손톱 재건술

권기두, 안병문, 이상목, 여용범

Abstract

Purpose
The fingernail defect is often a challenging problem for patients not only functional reasons but also aesthetic reasons. We performed microsurgical reconstruction of fingernail with arterialized venous free nail flap. Materials and Methods: Between November of 2003 and December of 2004, 5 toenail flaps were transferred for the reconstruction of fingernail defects. Age of the patients at operation ranged from 22 to 43 years (average 34.6 years). The causes of fingernail defect were traumatic crushing amputation. Crushed fingers were initially treated by 2 arterialized venous free flaps, 1 abdominal flap, 1 stump revision and 1 primary repair. The toenail flaps were harvested from 2nd toe including 2 dorsal cutaneous veins and anastomosis with recipient digital artery and dorsal vein respectively. Donor sites were covered with full-thickness skin grafts. Results: Complete flap survival was obtained in all cases. Growth of transferred nail was observed at 3 months after operation. Thin nail with hook nail deformity was occured at one case but clinically, satisfactory results were obtained in all cases according to the evaluation score. Conclusion: For fingernail reconstruction, arterialized venous free nail flap is one of the useful method.

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