Transplantation of slice nail bed flap of great toe with vascular anastomosisin repairing nail bed and soft tissue defect of fingers
10.3760/cma.j.issn.1001-2036.2019.01.003
- VernacularTitle:吻合血管的(踇)趾断层甲床皮瓣移植修复手指甲床及软组织缺损
- Author:
Muwei LI
1
;
Lifeng MA
;
Honggang WANG
;
Shaogeng HUANG
;
Gong WU
;
Zhe ZHANG
;
Yanjun YANG
;
Ziqing ZHANG
Author Information
1. 深圳市龙岗区骨科医院手显微外科 518116
- Keywords:
Nail bed defect;
Nail bed fiap of great toe;
Vascular anastomosis;
Repair
- From:
Chinese Journal of Microsurgery
2019;42(1):5-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical effect of transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers.Methods From January,2015 to March,2018,16 cases (16 fingers) of partial nail-bed defect at fingers were repaired with transplantation of slice nail bed flap of great toe with vascular anastomosis.All cases were combined with palmar soft tissue defect at distal segment fingers.The area of nail bed defects were from 0.8 cr×0.5 cm to 1.2 cm×1.0 cm.The area of soft tissue defects were from 1.2 cm×1.0 cm to 2.5 cm×1.5 cm.The average time from injury to operation was 3.6 hours after injuries (ranging from 1 hour to 8 hours).The area of slice nail bed flap incised during operation were from 2.5 cm×1.2 cm to 3.2 cm×1.8 cm,and the donor site was sutured directly.All patients were followed-up regularly for nail appearance,function and donor healing.Among them,11 cases were followed-up by clinic,4 cases by WeChat,and telephone follow-up was performed in 1 case.Results The nail-bed flap after transplantation survived successfully.The followed-up time were from 6 to 18 months,the average time was 9 months.Longitudinal spine and rough appearance occurred in 1 case.Others were flat,smooth,complete attachment of nail body and nail bed.The flaps had good appearance,texture and elasticity at 6 months after surgery,and two-point discrimination was 6-12 mm(average,8 mm).The toenails at donor sites grew well.No walk-associated pain after long-term following-up.Six months after surgery,according to standard for efficacy evaluation of nail regeneration,12 cases were excellent,3 cases were good and 1 case was acceptable.Conclusion Transplantation of slice nail bed flap of great toe with vascular anastomosis in repair of partial nail-bed and soft tissue defect at fingers is one of the effective methods for repairing nail-bed defect at fingers.
