title: Restoration of the nail apparatus following fingertip amputation by perionychial grafts supported by local flaps, in children and adults.
abstract: Fingertip amputations are a common injury in both adults and children. Replantation with revascularisation provides the gold standard result but is not always possible due to lack of expertise, degree of injury or patient factors. Perionychial grafts harvested from the amputated digit tip, anatomically restored and supported by a local flap are already known to be an effective option in the treatment of adult fingertip amputations. Such procedures can be performed by surgeons familiar with local flap techniques, can result in nail apparatus survival even with greater degrees of tissue injury and do not require prolonged protection or immobilisation. We present a consecutive series of four adults and four children who underwent perionychial grafts with flap support, to report the range of nail apparatus outcomes and to demonstrate this technique's relative utility in children.
authors.affiliation: Department of Plastic and Reconstructive Surgery, West Wing, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK. davidjohnson@doctors.org.uk
authors.forename: David
authors.initials: D
authors.lastname: Johnson
authors.forename: Henk
authors.initials: H
authors.lastname: Giele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000637:transplantation*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D055815:Young Adult