The curative effect of nail bed transplantation for repairing nail bed defect in one stage / 中华骨科杂志

ABSTRACT

Objective To investigate the efficacy of repairing finger nail bed defects by split-thickness nail bed grafts in one stage, and evaluate the functional recovery of nail beds comprehensively. Methods From February 2000 to December 2003, 33 fingers with nail bed defect in 26 patients (7 thumbs, 13 index fingers, 9 middle fingers, 4 ring fingers) were repaired with middle thickness grafts of nail bed harvested from the residual nail beds of the same fingers or from nail beds of 1st, 2nd and 3rd toes. Brachial plexus block or regional anesthesia was used. When the area of nail bed defect area was less than one third of the nail, the graft was taken from the same finger under rubber tourniquet. In condition of the area of nail bed defect larger than one third of the nail beyond nail plica or two nail bed defects, the grafts were taken from the nail beds of 1st, 2nd and 3rd toes. Results In the study, there were 23 fingers (18 patients) with the nail bed defects area more than 5 mm and less than one third of the nail repaired with the grafts of the same finger nail; there were 10 fingers (8 patients) with the nail bed defects more than one third of the nail beyond the nail plica or two nail bed defects transplanted with toe nail bed. All patients were followed up from 6 months to 30 months with an average of 17 months, all grafts survived very well. No pain, no infection and obvious deformed growth of nail were found, and a sound recovery was obtained in all patients. Excellent and good rates were 87.9% in 23 patients with 29 fingers; poor rate was 12.1% in 3 patients with 4 fingers according to the criteria by L? Gui-xin. Conclusion The transplantation of middle split-thickness nail bed to repair nail bed defect is simple and easy to operate. The grafted nail can grow in good appearance, and the deformation rate is lower.