Benefits of an Ungual Prosthesis in Traumatology and Reconstructive Surgery of the Nail

Abstract

Lesions of the nail apparatus can leave esthetic and sometimes functional sequelae. Many sequelae are the result of incorrect growth of the nail plate. During the acute phase, in the absence of a nail plate, the nail bed may keratinize or form a pyogenic granuloma, compromising harmonious regrowth of the nail plate. The ideal is to reinsert the plate if it is available, but if it has been lost, an ungual prosthesis must be inserted to act as a temporary implantable splint. This implant must have the same shape and structure as the nail plate. Many ideas have been used in the past, including suture pack, infusion tubing, or x-ray film. However, these techniques are no longer acceptable, as, in many countries, all types of implants require a documented recorded identification or "traceability." The implants we use are packed individually in sterile packaging. They are therefore immediately available in traumatology departments treating Hand Emergencies. These prostheses are also very useful in reconstructive surgery of the digit in the hand and feet, particularly when the nail bed has to be reconstructed. In this case, the implant is used to flatten the nail bed, whether it is sutured, grafted, or reconstructed with flaps, during the slow regrowth of the nail plate. The author reports his experience in emergency or secondary repair of the nail complex.