title: [Repair of severe nail bed defects with radial dorsal fasciocutaneous flap of thumb].
abstract: OBJECTIVE
  To summarize the effectiveness of radial dorsal fasciocutaneous flap of thumb for repairing severe nail bed defects.
  
  
  METHODS
  Between May 2009 and January 2012, 16 patients with severe nail bed defect were treated with radial dorsal fasciocutaneous flap of the thumb. There were 10 males and 6 females, aged 16-54 years (mean, 36 years). The causes of injury included crush injury in 10 cases, chainsaw injury in 4 cases, and scald in 2 cases; injured fingers were thumb in 3 cases, index finger in 4 cases, middle finger in 5 cases, ring finger in 3 cases, and little finger in 1 case. The time between injury and operation was 2 hours to 8 days (mean, 19.3 hours). Of 16 patients, 9 complicated by distal phalanx fracture. The area of defect ranged from 0.9 cm x 0.6 cm to 2.3 cm x 2.1 cm. According to ZHOU Qingwen's grading system for nail bed defects, 6 cases were rated as degree III and 10 cases as degree IV. The area of flap ranged from 1.0 cm x 0.6 cm to 2.5 cm x 2.2 cm. Retrograde transposition was performed to repair the thumb defect, and pedicled transposition to repair the 2nd-5th fingers defects. The donor sites were directly sutured or were repaired with skin graft.
  
  
  RESULTS
  All flaps and skin grafts survived, and wounds healed by first intention. All patients were followed up 6-12 months (mean, 8 months). The color, texture, and contour of the flaps were good. According to total active motion standard, the finger function was assessed as excellent in 10 cases, good in 4 cases, and fair in 2 cases, and the excellent and good rate was 87.5%.
  
  
  CONCLUSIONS
  Radial dorsal fasciocutaneous flap of thumb is a reliable flap with easy dissection and less trauma in repair of severe nail bed defects.
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, Jinan Shandong, 250031, PR China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Liu
authors.forename: Xiaohen
authors.initials: X
authors.lastname: Ding
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Jiao
authors.forename: Hongxun
authors.initials: H
authors.lastname: Zhang
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Qu
authors.forename: Kai
authors.initials: K
authors.lastname: Jiang
authors.forename: Xuecheng
authors.initials: X
authors.lastname: Cao
mesh_terms: D000293:Adolescent; D000328:Adult; D005205:Fascia / Q000637:transplantation; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012867:Skin / Q000293:injuries; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult