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Nail regeneration in digits replanted after amputation through the distal phalanx
1Department of Orthopaedic Surgery, Aichiken Koseiren Kainan Hospital, Aichi, Japan.
The Journal of Hand Surgery
|March 1, 1996
Summary
Nail regeneration after digit replantation depends on amputation level. Distal amputations (zone I) near the nailbed show better nail regrowth than proximal ones (zone II) which risk germinal matrix damage.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Hand Surgery
Background:
- Nail regeneration is a critical outcome following digital replantation.
- Amputation levels vary, impacting the viability of nail structures.
- Understanding factors influencing nail regrowth is essential for surgical success.
Observation:
- 48 digits were replanted after amputation through the distal phalanx.
- Amputations were categorized into Tamai's zone I (nailbed level) and zone II (proximal to nail).
- Nail regeneration was assessed in relation to the amputation zone and postoperative healing.
Findings:
- Nearly normal nail regeneration occurred in 9/27 zone I and 14/21 zone II replantations.
- Amputations distal to the lunula demonstrated near-normal nail regeneration with minimal circulatory issues.
- Amputations proximal to the lunula had higher rates of germinal matrix damage, leading to impaired nail growth.
Implications:
- Surgical planning for digital replantation should consider the lunula and germinal matrix.
- Preserving the germinal matrix is crucial for optimal nail regeneration outcomes.
- Minimizing postoperative circulatory disturbance enhances nail regrowth potential in replanted digits.