Restoration of the Injured Fingertip with Eponychial Cutaneous Flap

Kim, Ho Kil; Kim, Cheol Hann; Kang, Sang Gyu; Jung, Sung Gyun; Kim, Yong Bae

Abstract

The restoration of the fingernail is not simple in case of amputated distal fingertip which involved the pulp and nail. The nail should maintain a length of at least 2mm from the eponychium for an adequate grip and decent appearance. Various methods to reconstruct the fingernail bed are available. The nail bed graft from amputated finger or great toe, and free onychocutaneous flap are commonly used. The nail bed of the injured tip tends to be atrophied, deformed and failed as a graft. And the great toe is often turned down as a donor. We have restored satisfactorily the nail beds of three injured finger tips with eponychial cutaneous flaps. The pulps were reconstructed with either a reverse dorsal digital island flap or free pulp graft. Repeated again. A mean follow- up was six months. The nail grew up to the average of 3.7mm. All patients were satisfied with the length of the nail and met with good cosmetic results. An eponychial cutaneous flap is useful to restore the nail of the distal fingertip amputation. The procedure is relatively simple and morbidity is minimum.