title: Aesthetic and functional results from nailfold recession following fingertip amputations.
abstract: OBJECTIVE
  To analyze the aesthetic and functional results of a technique for nail salvage by recessing the nailfold to increase the exposed nail matrix after fingertip amputation.
  
  
  METHODS
  Thirty cases of fingertip amputation with distal partial nail bed defects underwent nailfold recession and pulp reconstruction. We increased nail bed exposure by recessing a rectangle flap of eponychium and reconstructed the pulp with different local flaps depending on the injury geometry. A 0.3- to 0.4-cm-wide rectangular strip of eponychium was de-epithelialized. The eponychial flap was separated from the nail matrix and slid proximally to expose more nail matrix, thereby effectively lengthening the exposed nail bed.
  
  
  RESULTS
  The flaps survived in all patients. The exposed nail beds were lengthened 0.3 to 0.4 cm and enlarged 38% to 100%. The fingertips had smooth and natural nail plates with inconspicuous scars on both the eponychium and pulp and no deformities. The sensation and mobility of injured and uninjured contralateral fingers did not differ statistically. All patients were satisfied with the appearance and function of the reconstructed fingertips.
  
  
  CONCLUSIONS
  Nailfold recession combined with different local flaps provided for the aesthetic and functional restoration of the fingertip after amputation with partial nail bed defect.
authors.affiliation: Department of Plastic, Hand and Aesthetic Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shuliang
authors.initials: S
authors.lastname: Xing
authors.affiliation: Department of Plastic, Hand and Aesthetic Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zunlishen12345@sina.cn.
authors.forename: Zunli
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of Plastic, Hand and Aesthetic Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wanxin
authors.initials: W
authors.lastname: Jia
authors.affiliation: Department of Plastic, Hand and Aesthetic Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yanxian
authors.initials: Y
authors.lastname: Cai
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects*; D004954:Esthetics; D005260:Female; D005385:Fingers / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013524:Surgical Flaps; D055815:Young Adult
keywords: Fingertip amputation; local flap; nail bed; nailfold recession; soft tissue