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Fingertip reconstruction with flaps and nail bed grafts
R E Brown1, E G Zook, R C Russell
1Division of Plastic Surgery, Southern Illinois University School of Medicine, Springfield 62794-9248, USA.
The Journal of Hand Surgery
|April 8, 1999
Summary
This study shows that combining local/regional flaps with nail bed grafts effectively reconstructs crushed fingertips. Most reconstructions achieved successful soft tissue healing and good nail growth.
Area of Science:
- Hand surgery
- Reconstructive surgery
Background:
- Fingertip injuries, particularly crushing injuries, pose significant reconstructive challenges.
- Effective soft tissue coverage and nail bed reconstruction are crucial for functional and aesthetic outcomes.
Observation:
- A retrospective review of 14 fingertip reconstructions using combined local/regional flaps and nail bed grafts was conducted.
- Various flaps (palmar V-Y, thenar, lateral V-Y, Moberg, cross-finger) and nail bed graft sources (toenail, amputated part, injured digit) were utilized.
Findings:
- The combined flap and graft technique demonstrated high success rates, with only minor partial graft and flap loss in one case each.
- Excellent soft tissue healing and satisfactory nail growth and adherence were observed in the majority of reconstructions.
- One case required secondary composite grafting due to initial graft complications.
Implications:
- This reconstructive strategy offers a viable solution for complex fingertip injuries.
- The findings support the use of combined flaps and grafts for achieving successful fingertip reconstruction and restoring nail function.
- Further research could explore optimal flap and graft choices for specific injury patterns.