Chularat 3 Hospital, Bang plee, Samut Prakarn, Thailand.
Tech Hand Up Extrem Surg. 2020 Dec 22;25(3):201-205. doi: 10.1097/BTH.0000000000000333.
Hooked fingernail deformity can develop after any type of fingertip amputation. A more proximal amputation is associated with a higher probability of developing hooked fingernails. Proximal fingertip amputations with very short remaining nail beds are recommended for revision amputation with nail bed ablation. This procedure eliminates the possibility that the patient may have a functional nail. When the nail matrix is still retained, an oblique triangular neurovascular island flap may preserve the nail and digit length. At our institution, the modified oblique triangular neurovascular island flap is routinely used for patients who underwent fingertip amputation with a retained nail bed. These modifications may aid in preventing the development of hooked nail deformity and creating a round pulp contour without the need for fixation, composite grafts, or distant soft tissue transfer.
钩状指甲畸形可在任何类型的指尖离断后发生。更靠近指尖的离断与钩状指甲畸形的发生概率更高相关。对于指甲床非常短的近端指尖离断，建议行 Revision amputation with nail bed ablation。该手术可以消除患者拥有功能性指甲的可能性。当甲母质仍然保留时，斜三角状的神经血管岛状皮瓣可以保留指甲和指骨长度。在我们的机构中，改良斜三角状的神经血管岛状皮瓣被常规用于那些保留有指甲床的指尖离断患者。这些改良方法可能有助于预防钩状指甲畸形的发展，并在无需固定、复合移植或远处软组织转移的情况下，塑造出圆形的甲床轮廓。
