Reconstruction of thumb and finger nail defects by using hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis

Abstract

Objective To evaluate the method and clinical effect of hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis in the reparation thumb and finger nail defects.Methods From January 2010 to October 2012,three cases with thumb nail defects and 9 cases with finger nail defects were repaired by the hallux toenail flap transplantation.The dorsal branch of proper plantar artery of toenail flap was anastomosed with proper palmar digital artery or dorsal branch of proper palmar digital artery; using suture,dermatoplasty and hallux fibular flap to repair the donor site of hallux.Results All 12 cases of grafted hallux toenail flaps survived.All patients revealed favorable functions and growth of nail,nine cases of the grafted hallux toenail appearance was smooth and outline were satisfied,two case of the grafted hallux toenail was not smooth,one case of the grafted hallux toenail was obvious contracture and scar hyperplasia around the suture after 4-14 months followed-up,there was no abrasion to break happened in the area of dermatoplasty and flap.Conclusion It is a smaller injury and reliably method that using hallux toenail flap transplantation with dorsal branch of proper plantar artery anastomosis to repair the thumb and finger nail defects. Key words: Hallux toenail flap; Proper plantar artery; Thumb; Finger; Nail bed