Transfer of phalangeal flap from the big toe for treatment of hook nail deformity

Abstract

Objective To introduce the methods of using phalangeal flap from the big toe to repair hook nail deformity of the finger. Methods Scar tissue of the stump along with the nail was removed first. The distal phalangeal flap from the big toe was transferred to the stump. The bone flap was used to repair the missing distal phalanx, while the hook-shaped nail bed was lifted and tiled over the bone flap. The skin and subcutaneous tissue of the tissue flap covered the soft tissue defects of the finger. Results The transplanted tissues survived uneventfully in all 3 cases. Follow-up evaluations after more than two years showed significant improvement in the shape of the distal finger. There was no need for secondary plastic surgery. The nail was 1.0, 2.5 and 3.0 mm shorter than normal, respectively, in these three cases. Two-point discrimination of the pulp was 8 to 12 mm. Conclusion Phalangeal flap transfer from the big toe is an effective method to treat hook nail deformity of the finger. Key words: Nails; Surgical flaps; Hook nail deformity