Primary functional and aesthetic restoration of the fingernail in distal fingertip amputations with the eponychial flap

Fingertip injuries often result in fingernail defects. Reconstruction of this structure is important for adequate functional and aesthetic results. This study evaluates the eponychial flap reconstruction technique in 45 fingertip amputations with loss of more than half the fingernail. In 33 cases th...

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Bibliographic Details
Published in:The Journal of hand surgery, European volume European volume, 2014-06, Vol.39 (5), p.499-504
Main Authors: Fakin, R. M., Biraima, A., Klein, H., Giovanoli, P., Calcagni, M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Amputation, Traumatic
Child
Child, Preschool
Female
Finger Injuries - surgery
Humans
Male
Middle Aged
Nails - surgery
Reconstructive Surgical Procedures
Retrospective Studies
Surgical Flaps
Young Adult
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Summary:Fingertip injuries often result in fingernail defects. Reconstruction of this structure is important for adequate functional and aesthetic results. This study evaluates the eponychial flap reconstruction technique in 45 fingertip amputations with loss of more than half the fingernail. In 33 cases the procedure was performed in combination with a palmar island flap for pulp reconstruction. Average follow up was 5 months. All eponychial flaps healed uneventfully. In 44 cases, the pulp volume was restored without nail growth disturbance. Five complications (9%) were observed (pain, soft nail, and nail deformity). Only one hook nail deformity required reoperation. All patients were satisfied with the aesthetic and functional outcome. We found eponychial flap fingernail reconstruction effective even for injuries proximal to the lunula and have extended the indication for this technique to very proximal fingernail defects. Eponychial flap reconstruction is a simple, safe, and time-effective technique without donor site morbidity. Simultaneous reconstruction of dorsal and palmar injuries should both be performed primarily resulting in the restoration of a satisfying fingertip.
ISSN:1753-1934
2043-6289
DOI:10.1177/1753193413489794