Grafting and Other Reconstructive Options for Nail Deformities: Indications, Techniques, and Outcomes

Nail dystrophy for the surgeon

Injuries to the fingertips are the most frequently occurring damage to the hand. The nail is an exceptional structure within the human body that offers both stability and protection, as well as the ability to perform fine and precise movements. Nail dystrophies are numerous, post-traumatic, post-infection or even degenerative. They raise many difficulties for the treating hand surgeon. Which anatomical structure is dystrophic? Is there any secondary fungal superinfection to be treated before surgery? Among the various techniques proposed, which one will help to improve my patient as a complete cure is rarer than partial failures. In this chapter we have chosen to describe the surgical techniques, their difficulties and drawbacks, that are available for the most frequent dystrophies that the hand surgeons may treat.

Nail Reconstruction With Nail Bed Graft From Big Toe: A Case Report

Fingertip injuries with loss of the nail bed can lead to permanent deformities or absent nail formation. This is a case report of a 17-year-old female who sustained a blunt injury to the left second index finger with nail avulsion. The patient underwent nail reconstruction with a split-thickness graft from the sterile matrix of the left great toe. Postoperatively both the donor and the recipient sites appear to be healing appropriately. Since nail reconstruction with toe graft is rarely performed, this case is of particular interest due to its excellent postoperative outcomes.