J Korean Orthop Assoc.  2009 Aug;44(4):449-454.

Nail Lengthening using the Eponychial Flap

• Lee CH
• Jeong JM
• Kim J
• Lim ST
• Yoo KH
• Park RP
• Kim MB

Abstract

PURPOSE
We wanted to introduce a nail lengthening technique with an eponychial flap for treating finger tip amputation, and we review the relevant literature. MATERIALS AND METHODS: Twenty-five patients who received eponychial flap surgery between November 2001 and April 2006 were enrolled in this study. Retrospectively, the patients were asked, by using a questionnaire, about their satisfaction with their nail shape and length. The preoperative findings and the findings at the last follow up and the contralateral finger nail lengths were measured with a ruler and those were all compared according to the percentage of change. RESULTS: The average operation time was fourteen minutes (range: 10 to 19 minutes). All the flaps survived and there was no infection, congestion of the flap, or additional deformity of nail. The average follow up period was five months. The nails were lengthened an average of 0.35 cm. The last follow up questionnaire showed that the patients were satisfied with their nail's appearance with an average score of 95.5 points. CONCLUSION: Nail lengthening using an eponychial flap is a convenient, safe and aestheticall pleasing procedure.

Keyword

Nail injury; Eponychial flap; Nail lengthening

MeSH Terms

Amputation
Congenital Abnormalities
Estrogens, Conjugated (USP)
Fingers
Follow-Up Studies
Humans
Nails
Surveys and Questionnaires
Retrospective Studies
Estrogens, Conjugated (USP)

Figure

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  Fig. 1 (A) A rectangular figure is drawn at a length of 0.5 to 0.6 cm from the eponychium. It is 0.2 to 0.3 cm long and as wide as the residual nail. (B) The eponychium is detached from the underlying nail and bilaterally incised. The rectangular area is de-epithelialized with the underlying vascular bed intact. The eponychial flap is transposed backward. (C) Sutures over the de-epithelialized area make the visible nail longer.

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  Fig. 2 (A) A patient of 26 year-old man sustanined an amputation injury at a right long finger tip. (B) The radiographic image of the same patient shows a bone defect of the distal phalanx. (C) This figure shows an eponychial flap and an artificial nail insertion of a finger. (D) The volar V-Y advancement flap covers the fingertip amputation defect. (E) The picture of the 18 months' follow-up presents the excellent nail shape and length compared with adjacent nails.

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