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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(06): 764-768
DOI: 10.1055/s-0042-1757573
Hand/Peripheral Nerve
Idea and Innovation

Easy and Simple Techniques to Reconstruct Natural Nailfold with the Wrap-around Flap for Finger Reconstruction

Takeo Matsusue 
1   Department of Plastic Reconstructive Surgery, Kansai Electric Power Hospital, Osaka, Japan
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Abstract

The wrap-around flap (WAF) has become a popular approach to thumb reconstruction because the results are functionally and cosmetically excellent. By modifying to a partial toenail transfer, the WAF can also be used for finger reconstruction. However, performing cosmetically superior finger reconstruction is a significant challenge because it is difficult to reconstruct the natural nailfold by partial nail transplantation, although partial nail transplantation is required to reconstruct a narrow fingernail. One side of the reconstructed lateral nailfold tends to be a missing nail margin, and one side of the proximal nailfold angle tends to be retracted. Based on the rationale that loss of the lateral nailfold volume due to the postoperative tension of the volar flap would result in a missing nail margin, the volume of the lateral nailfold was maintained with a single thread that was passed from the nail to the volar flap. Additionally, half of the proximal nailfold from the nail plate was elevated to advance it forward. The results indicated that a cosmetically natural nailfold was achieved with the WAF approach to finger reconstruction. These easy and simple techniques enable reconstruction of a cosmetically natural nailfold using WAF for finger reconstruction.

Keywords

nail - finger - free flaps - finger injuries - surgical flaps

Ethical Approval

The study was approved by the Institutional Review Board of Kansai Electric Power Hospital (IRB no. 21–114) and performed in accordance with the principles of the Declaration of Helsinki.Patient Consent


Patient Consent

The patients provided written informed consent for the publication and the use of their images.




Publikationsverlauf

Eingereicht: 30. März 2022

Angenommen: 30. Juni 2022

Artikel online veröffentlicht:
13. Dezember 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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