Microsurgical Reconstruction of Finger Tip and Associated Nail Defect

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Journal of the Korean Society for Surgery of the Hand 2008;13(3):147-153.
Published online September 1, 2008.

Noh Seung Man, Sae Hwi Ki, Jin Soo Kim, Dong Chul Lee, Si Young Roh, Jae Won Yang

미세 수술을 이용한 수지 첨부 결손과 동반된 조갑결손의 재건

노승만, 기세휘, 김진수, 이동철, 노시영, 양재원

Abstract

The fingernail plays important roles such as fascilitating tactile sensibility, tip pinching of finger pulp, scratching something, protecting of finger pulp and also has aesthetic importance. In case of fingertip injury, fingernail and distal phalanx defects were commonly accompanied with. For the fingernail reconstruction, the coverage of the pulp and the distal phalanx are needed in most cases. At Sung-Ae General hospital, microsurgical operation was conducted for the reconstruction of the fingertip and fingernail defect by harvesting the toenail, pulp and distal phalanx of one toe simultaneously in 18 cases among 17 patients. Reconstructions were classified by defected nail type and the defect of distal phalanx as followings: partial vertical onychocutaneous flap (4 cases), partial transverse onychocutaneous flap (4 cases), partial vertical osteoonycocutaneous flap (1 case), total onychocutaneous flap (3 cases), total osteoonycocutaneous flap (6 cases). As a result, fingertip and fingernail were reconstructed at the same time and the atrophy or deformity was not shown at transferred nail and distal phalanx. Donor site was sutured primarily after trimming bone and cosmetic impairment was appeared at acceptable level.

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