Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series
Purpose: Fingertip trauma and amputations, when not treated correctly, can evolve unfavorably, leading to pain, loss of strength, and tactile difficulties. Post-traumatic nail changes are not just a cosmetic complaint as the nail, along with its protective function, also helps to stabilize the finge...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-05-01
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| Series: | Journal of Hand Surgery Global Online |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589514125000350 |
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| author | Ricardo Kaempf de Oliveira, MD Paula Fischer, MD Luna Hussein Colombelli, MD Monique Alves, MD Pedro Delgado, MD, PhD Matias Craviotto, MD, PhD |
| author_facet | Ricardo Kaempf de Oliveira, MD Paula Fischer, MD Luna Hussein Colombelli, MD Monique Alves, MD Pedro Delgado, MD, PhD Matias Craviotto, MD, PhD |
| author_sort | Ricardo Kaempf de Oliveira, MD |
| collection | DOAJ |
| description | Purpose: Fingertip trauma and amputations, when not treated correctly, can evolve unfavorably, leading to pain, loss of strength, and tactile difficulties. Post-traumatic nail changes are not just a cosmetic complaint as the nail, along with its protective function, also helps to stabilize the fingertip, adding to pinching motion. There are techniques that provide the nail complex improvement for the treatment of post-traumatic sequelae, thus enhancing fingertip function and aspect. Methods: We have used a rectangular, eponychium flap with an indentation in the eponychial fold that increases the exposure of the nail matrix in a series of 19 digits in 18 patients. The indication was pain, deformity, and post-traumatic shortening of the nail, for at least 3 months after the initial injury. Results: The size of the flap and consequent nail size increase averaged 3.44 mm. There were no instances of necrosis or any other serious complication requiring a second procedure. Regarding function satisfaction, 11 patients regarded the results as excellent; six reported good outcomes; and one had a fair result. As for appearance, 11 considered the results as excellent, and seven as good. Conclusion: We conclude that the eponychium flap performed to increase the size and improve the shape of the nail is a safe, reproducible procedure that generates good cosmetic and functional results, presenting a low rate of complications. It poses few risks and can be associated with the volar flap for pulp reconstruction, without any result change. Type of study/level of evidence: Therapeutic I. |
| format | Article |
| id | doaj-art-9a409b66484541faa67fa0923492b506 |
| institution | Kabale University |
| issn | 2589-5141 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj-art-9a409b66484541faa67fa0923492b5062025-08-20T03:47:41ZengElsevierJournal of Hand Surgery Global Online2589-51412025-05-017310071610.1016/j.jhsg.2025.02.009Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case SeriesRicardo Kaempf de Oliveira, MD0Paula Fischer, MD1Luna Hussein Colombelli, MD2Monique Alves, MD3Pedro Delgado, MD, PhD4Matias Craviotto, MD, PhD5Hand Surgeon at Santa Casa de Misericórdia Hospital, Porto Alegre, Brazil; Corresponding author: Ricardo Kaempf de Oliveira, MD, PhD, Rua Leopoldo Bier, 825, Conjunto 301, Porto Alegre, RS, 90620-100, Brazil.Orthopedic Resident at Santa Casa de Porto Alegre, Porto Alegre, BrazilOrthopedic Resident at Santa Casa de Porto Alegre, Porto Alegre, BrazilHand Surgeon at São Lucas da PUC Hospital, Porto Alegre, BrazilHand Surgeon at Madrid Montepríncipe University Hospital, CEU San Pablo University, Madrid, SpainHand Surgeon at Clínica de Mano, Montevideo, UruguayPurpose: Fingertip trauma and amputations, when not treated correctly, can evolve unfavorably, leading to pain, loss of strength, and tactile difficulties. Post-traumatic nail changes are not just a cosmetic complaint as the nail, along with its protective function, also helps to stabilize the fingertip, adding to pinching motion. There are techniques that provide the nail complex improvement for the treatment of post-traumatic sequelae, thus enhancing fingertip function and aspect. Methods: We have used a rectangular, eponychium flap with an indentation in the eponychial fold that increases the exposure of the nail matrix in a series of 19 digits in 18 patients. The indication was pain, deformity, and post-traumatic shortening of the nail, for at least 3 months after the initial injury. Results: The size of the flap and consequent nail size increase averaged 3.44 mm. There were no instances of necrosis or any other serious complication requiring a second procedure. Regarding function satisfaction, 11 patients regarded the results as excellent; six reported good outcomes; and one had a fair result. As for appearance, 11 considered the results as excellent, and seven as good. Conclusion: We conclude that the eponychium flap performed to increase the size and improve the shape of the nail is a safe, reproducible procedure that generates good cosmetic and functional results, presenting a low rate of complications. It poses few risks and can be associated with the volar flap for pulp reconstruction, without any result change. Type of study/level of evidence: Therapeutic I.http://www.sciencedirect.com/science/article/pii/S2589514125000350AmputationFinger injuriesHand surgeryNail injuriesSurgical flaps |
| spellingShingle | Ricardo Kaempf de Oliveira, MD Paula Fischer, MD Luna Hussein Colombelli, MD Monique Alves, MD Pedro Delgado, MD, PhD Matias Craviotto, MD, PhD Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series Journal of Hand Surgery Global Online Amputation Finger injuries Hand surgery Nail injuries Surgical flaps |
| title | Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series |
| title_full | Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series |
| title_fullStr | Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series |
| title_full_unstemmed | Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series |
| title_short | Chronic Posttraumatic Nail Reconstruction with an Eponychium Flap: Technique Description and Case Series |
| title_sort | chronic posttraumatic nail reconstruction with an eponychium flap technique description and case series |
| topic | Amputation Finger injuries Hand surgery Nail injuries Surgical flaps |
| url | http://www.sciencedirect.com/science/article/pii/S2589514125000350 |
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