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Thin split-thickness toenail bed grafts for avulsed nail bed defects.

Shang-Chin Hsieh¹, Shao-Liang Chen, Tim-Mo Chen

¹Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.

Annals of Plastic Surgery

|April 16, 2004

Summary

For fingernail bed injuries, a thin split-thickness toenail graft effectively restores a normal nail. This surgical technique ensures excellent results without donor site deformities, making it ideal for acute nail bed avulsion.

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Area of Science:

Hand surgery
Reconstructive surgery
Dermatology

Background:

Avulsed fingernail bed defects are common in hand trauma.
Improper management can result in irregular, nonadherent nails.
Nail bed reconstruction is crucial for functional and aesthetic outcomes.

Observation:

A thin split-thickness sterile matrix graft from the great toe was utilized.
The graft was used for immediate replacement of nail bed defects.
The study included 13 fingers in 12 patients between May 1998 and December 2001.

Findings:

The technique successfully restored smooth, adherent, and normal-looking nails.
Excellent end results were achieved in all cases.
No deformities were observed at the graft donor site (great toe).

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Implications:

Thin split-thickness toenail bed grafts are a viable treatment option for acute nail bed avulsion.
This method offers a reliable solution for restoring nail integrity and appearance.
It presents a safe and effective reconstructive approach in hand trauma management.