Primary Reconstruction of Fingernail Injuries in Children with Split-Thickness Nail Bed Grafts
European Journal of Pediatric Surgery, 08/17/2012

Rohard I et al. – Primary reconstruction of complex nail bed injuries with split–thickness nail bed grafts (STNBGs) usually gives good cosmetic and functional results in children and prevents secondary nail growth disturbances reliably.

• A retrospective, single center case series of nine fingers with complex nail bed injuries that were reconstructed primarily with STNBGs was performed.
• Surgical outcome and patient satisfaction were assessed.

• For six nail bed reconstructions, the nail bed graft was harvested from the injured finger, and for the remaining three from the great toe.
• Harvesting of the great toe's nail bed could be performed without removal of the nail plate by only lifting it up distally.
• Insufficient vascularization required primary flap coverage in six cases with three Moberg flaps, two palmar V-Y flaps, and one thenar flap.
• No flap was lost and all nail bed grafts had a 100% take.
• Only one patient required reoperation due to a hook- and split-nail deformity. All other patients were satisfied or very satisfied and the surgical outcome was least satisfactory in all but two patients.