Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Université Libre de Bruxelles, Belgium.
Hand (N Y). 2023 Jun;18(4):648-654. doi: 10.1177/15589447211064359. Epub 2021 Dec 28.
The regenerative potential of the nail bed after trauma remains controversial.
We performed a retrospective review of 51 patients who underwent nail bed reconstruction with 2 techniques (direct flow island flap or a Tranquilli-Leali "Atasoy" flap) due to trauma involving the nail bed complex. These 2 flaps were used to support the loss of distal substance and to allow the regeneration of the nail bed. Outcomes were analyzed for at least 18 months. There were 34 men (66.7%), and the average age was 16.1 years. Most patients (56.9%) had crush injuries. The little (16) and index (14) fingers were the most affected. Twenty-seven were children (range: 4-11) with an average age of 7.4 ± 1.9 years. The middle finger was the most affected (29.2%).
The outcomes were good to excellent in 41 operated patients (80.4%). Hook nail was absent in 84.3% of the patients. Most patients (98%) did not develop necrosis. Children had an excellent/good outcome rate of 85.2%, while in adults, the rate was 75% of cases ( = .485).
The direct flow island flap is superior in terms of outcome, regardless of age, sex, affected finger, dominant hand, type of trauma, and injury zone. In cases where there was a correct reconstruction of the hyponychium, there was regeneration of the nail bed.
创伤后指甲床的再生潜力仍存在争议。
我们对 51 例因涉及指甲床复合体的创伤而接受指甲床重建的患者进行了回顾性研究，这些患者采用了 2 种技术（直接血流岛状皮瓣或 Tranquilli-Leali“Atasoy”皮瓣）。这两种皮瓣用于支撑远端物质的损失，并允许指甲床再生。对至少 18 个月的结果进行了分析。有 34 名男性（66.7%），平均年龄为 16.1 岁。大多数患者（56.9%）为挤压伤。小指（16 例）和食指（14 例）受影响最多。27 例为儿童（4-11 岁），平均年龄为 7.4±1.9 岁。中指受影响最严重（29.2%）。
41 例手术患者的结果为良好至优秀（80.4%）。84.3%的患者无钩状甲。大多数患者（98%）未发生坏死。儿童的优良率为 85.2%，而成年人的优良率为 75%（=0.485）。
直接血流岛状皮瓣在结果方面优于 Tranquilli-Leali“Atasoy”皮瓣，无论年龄、性别、受影响的手指、惯用手、创伤类型和损伤区域如何。在正确重建甲下结构的情况下，指甲床会再生。
