Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting

Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up. Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed. Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting ; volume:46 ; number:01 ; year:2019 ; pages:57-62
Archives of Plastic Surgery ; 46, Heft 01 (2019), 57-62

Beteiligte Personen und Organisationen
Lee, Kyung Jin
Kim, Yong Woo
Kim, Jin Soo
Roh, Si Young
Lee, Dong Chul

DOI
10.5999/aps.2018.00227
URN
urn:nbn:de:101:1-2022051211292323219478
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:35 MESZ

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Beteiligte

  • Lee, Kyung Jin
  • Kim, Yong Woo
  • Kim, Jin Soo
  • Roh, Si Young
  • Lee, Dong Chul

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