title: An algorithmic approach to posttraumatic nail deformities based on anatomical classification.
abstract: OBJECTIVE
  Most of the clinical series on posttraumatic nail deformities (PTNDs) address an individual deformity and its correction. The aim of the study was to classify PTND on the basis of its anatomical defect, devise the reconstructive modality and propose an algorithmic approach to PTND. We have also analysed our results of surgical correction and compared the data with the published literature.
  
  
  METHODS
  A 5-year retrospective study of 45 patients with PTND was conducted. The deformities were classified into three groups: intact nail bed, partially amputated nail bed and completely amputated nail bed on the basis of the remnant nail bed.
  
  
  RESULTS
  PTNDs with intact nail bed were present in 78%, with partially amputated nail bed in 16% and with completely amputated nail bed in 7% of the patients. Deformities in intact nail bed group were nonadherence (33%), ridged nail (31%), split nail (9%) and nail horn (4%). All patients with partially amputated nail bed presented with hooked nail deformity. A satisfactory result was seen in 87% of nonadherence, 71% of ridged nail, 50% of split nail and 57% of hooked nail. None of the patients with nail horn and absent nail showed a satisfactory result.
  
  
  CONCLUSIONS
  PTND with intact nail bed are consistently benefitted when the option is only split-thickness sterile matrix (STSM) grafting. Appreciable correction of hooked nail deformity can be achieved by the reconstruction of lost components. In our opinion, there is no role of split-thickness germinal matrix (STGM) and STSM graft transfer in total nail reconstruction.
  
  
  METHODS
  III.
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India. Electronic address: drashishrai@yahoo.co.in.
authors: Ashish
authors: A
authors: Rai
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.
authors: Manoj K
authors: MK
authors: Jha
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.
authors: Lalit K
authors: LK
authors: Makhija
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.
authors: Sameek
authors: S
authors: Bhattacharya
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.
authors: Nitin
authors: N
authors: Sethi
authors: Department of Burns, Plastic, Maxillofacial and Microvascular Surgery, PGIMER and Dr R.M.L. Hospital, New Delhi 110001, India.
authors: Shilpi
authors: S
authors: Baranwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000293:injuries* / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult
keywords: Hooked nail; Nail bed grafting; Nonadherence; Posttraumatic nail deformities; Ridged nail; Split nail; Total nail reconstruction