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Related Experiment Video

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An algorithmic approach to posttraumatic nail deformities based on anatomical classification.

Ashish Rai1, Manoj K Jha1, Lalit K Makhija1

  • 1Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|February 12, 2014
PubMed
Summary
This summary is machine-generated.

This study classifies posttraumatic nail deformities (PTNDs) by anatomical defect, proposing a reconstructive algorithm. Split-thickness sterile matrix grafting is effective for intact nail beds, while reconstruction aids hooked nail deformities.

Keywords:
Hooked nailNail bed graftingNonadherencePosttraumatic nail deformitiesRidged nailSplit nailTotal nail reconstruction

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Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Regenerative Medicine

Background:

  • Posttraumatic nail deformities (PTNDs) are common but often treated individually.
  • A comprehensive classification and reconstructive approach for PTNDs is lacking.
  • This study aims to classify PTNDs based on anatomical defects and propose a standardized treatment algorithm.

Purpose of the Study:

  • To classify posttraumatic nail deformities (PTNDs) based on anatomical nail bed defects.
  • To devise reconstructive modalities for various PTND classifications.
  • To propose an algorithmic approach for PTND management and analyze surgical outcomes.

Main Methods:

  • A 5-year retrospective study involving 45 patients with PTND.
  • Classification of PTND into three groups: intact, partially amputated, and completely amputated nail bed.
  • Analysis of surgical correction results and comparison with existing literature.

Main Results:

  • PTNDs with intact nail beds were most common (78%), presenting as nonadherence, ridged, split, or nail horn deformities.
  • Partially amputated nail beds (16%) primarily resulted in hooked nail deformities.
  • Satisfactory outcomes were achieved in 87% of nonadherence, 71% of ridged nails, 50% of split nails, and 57% of hooked nails. Nail horns and absent nails had poor outcomes.

Conclusions:

  • Split-thickness sterile matrix (STSM) grafting is beneficial for PTNDs with intact nail beds.
  • Reconstruction of lost components effectively corrects hooked nail deformities.
  • Split-thickness germinal matrix (STGM) and STSM grafts are not recommended for total nail reconstruction.