Abstract:

Objective　To summarize the clinical effects of nail transplantation with blood supply for reconstruction of thumb or finger nail defect.　Methods　From February, 2003 to February, 2011, we carried out 23 cases of toenail transplantation with blood supply to reconstruct thumb nail defect and 40 cases of toenail transplantation from the second  digit of the foot with blood supply to repair nail defect of the second to the fourth finger. And skin grafting or the pedicled local flap was carried out at the donor site of the foot.　Results　The wound healing of the patients were all primary, and all 23 transplanted thumb nails and 40 transplanted nails from the second digit of foot were all successful. We followed up 63 patients for 5～30 months and the average of follow-up time was 13 months. The patients we followed up were satisfied with the appearance of their reconstructed fingers. The nails grew well with good touch sensation, which could assist the finger pulp to do some actions such as grasping, pinching, or picking up a needle. The flexion of interphalangeal joint of the patients with repaired thumbs could reach 50°~90°,  with an average of 65°. And the distal interphalangeal joint flexion of the patients with repaired 2~4 fingers reached 30°~70° with an average of 50°. Two of the 48 donors for skin grafting had linear cicatricial contracture in feet. The contracture was relieved after a second surgery for cicatricle resection, and the texture of other skin grafting area was good with loose and soft skin.　 Conclusion　 Nail transplantation with blood supply from from the thumb and the second digit of the foot can can notably repair the appearance of the fingers and also rebuild the functions of nails.

Key words: Nail, Toenail, Microsurgery