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Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap.
Eplasty 2017; 17:e28E

Abstract

Background:

The goals of fingertip reconstruction are to achieve adequate soft-tissue coverage and a functional nail plate and to maintain sensation, proprioception, and cosmesis.

Objective:

We present a composite tissue graft and volar V-Y advancement flap for reconstruction of a traumatic amputation of a fingertip, which provided optimal preservation of the hyponychium and the volar pad for prevention of a hook nail. Historically, composite fingertip grafts have not been recommended for adults with large defects.

Methods:

The amputated nail bed, hyponychium, and a 10 × 20-mm segment of the fingertip were utilized as a composite graft for reconstruction of the nail bed in an adult. The addition of a volar V-Y advancement flap to reconstruct the fingertip was necessary for complete soft-tissue reconstruction.

Results:

The reconstruction resulted in nail plate adhesion without significant nail deformity and a functional and sensate fingertip.

Conclusion:

Components of amputated fingertips including the sterile matrix, hyponychium, and part of the fingertip can be utilized in a composite graft to yield satisfactory functional and cosmetic results in adults.

Authors+Show Affiliations

University of Louisville School of Medicine, Louisville, Kentucky.Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky.University of Louisville School of Medicine, Louisville, Kentucky.University of Louisville School of Medicine, Louisville, Kentucky.Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky.Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky.Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky.Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28943994

Citation

Henderson, Joshua T., et al. "Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap." Eplasty, vol. 17, 2017, pp. e28.
Henderson JT, Schulz SA, Swiergosz AM, et al. Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. Eplasty. 2017;17:e28.
Henderson, J. T., Schulz, S. A., Swiergosz, A. M., Hiller, A. R., Gunn, J. S., Choo, J. H., ... Wilhelmi, B. J. (2017). Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. Eplasty, 17, pp. e28.
Henderson JT, et al. Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. Eplasty. 2017;17:e28. PubMed PMID: 28943994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. AU - Henderson,Joshua T, AU - Schulz,Steven A, AU - Swiergosz,Andrew M, AU - Hiller,Andrea R, AU - Gunn,J Stephen, AU - Choo,Joshua H, AU - Kasdan,Morton L, AU - Wilhelmi,Bradon J, Y1 - 2017/09/08/ PY - 2017/9/26/entrez PY - 2017/9/26/pubmed PY - 2017/9/26/medline KW - advancement flap KW - composite graft KW - fingertip injury KW - hook nail KW - hyponychium SP - e28 EP - e28 JF - Eplasty JO - Eplasty VL - 17 N2 - Background: The goals of fingertip reconstruction are to achieve adequate soft-tissue coverage and a functional nail plate and to maintain sensation, proprioception, and cosmesis. Objective: We present a composite tissue graft and volar V-Y advancement flap for reconstruction of a traumatic amputation of a fingertip, which provided optimal preservation of the hyponychium and the volar pad for prevention of a hook nail. Historically, composite fingertip grafts have not been recommended for adults with large defects. Methods: The amputated nail bed, hyponychium, and a 10 × 20-mm segment of the fingertip were utilized as a composite graft for reconstruction of the nail bed in an adult. The addition of a volar V-Y advancement flap to reconstruct the fingertip was necessary for complete soft-tissue reconstruction. Results: The reconstruction resulted in nail plate adhesion without significant nail deformity and a functional and sensate fingertip. Conclusion: Components of amputated fingertips including the sterile matrix, hyponychium, and part of the fingertip can be utilized in a composite graft to yield satisfactory functional and cosmetic results in adults. SN - 1937-5719 UR - https://www.unboundmedicine.com/medline/citation/28943994/Preservation_of_the_Sterile_Matrix,_Hyponychium,_and_Fingertip_Pad_in_Fingertip_Reconstruction_With_Composite_Fingertip_and_Nail_Bed_Graft_and_Volar_V-Y_Advancement_Flap L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28943994/ DB - PRIME DP - Unbound Medicine ER -