Postburn nailfold retraction: A reconstructive technique

Abstract

Postburn nailfold retraction often results in nail deformity and loss of distal interphalangeal joint flexion. A technique of reconstruction of the nailfold using a proximally based transposition flap is described in a patient with postburn nailfold retraction of the left thumb, index and middle fingers.

Study of Yang's Onion Flap Technique for Release of Scarred Eponychium and Nail Fold Reconstruction in Burn Patients

“…However, it may not always be possible due to scarring of the skin in the involved finger. 6 Donelan has described a bipedicled proximally based flap in over 100 cases over 20 years reliably with good results; this technique uses a skin graft to cover donor site defects. 7 Yang described the technique for release of scarred eponychium and nailfold reconstruction in 2012 in 32 fingers with a 100% flap success rate.…”

“…5 Distally based flaps have a risk of precarious blood supply if they are raised very distally, and the digital nerve and vessels can be damaged while raising the flap leading to a decreased sensation and flap loss. 1 6 The proximally-based flaps can have a digital artery or branch included in the flap, but the flap still has the chance of digital nerve injury. This risk is because earlier flaps included skin from the finger's lateral side, which often encroached on the volar aspect.…”