title: Functional and aesthetic outcomes of the fingertips after nail lengthening using the eponychial flap.
abstract: BACKGROUND
  Eponychial flap technique is able to lengthen the visible nail and allow the preservation of the nail complex following fingertip amputations with nail bed involvement. The study assessed the functional and aesthetic outcomes of the reconstructed fingertips using the eponychial flap.
  
  
  METHODS
  Eponychial flaps were performed in 11 fingertip amputations. Two-point discrimination, light touch, Purdue dexterity test, and pinch power of the reconstructed digits were examined. Patient-reported outcomes including subjective pain, Michigan Hand Outcome Questionnaire, and visual analog scale for appearance were documented. For comparison, nine patients with similar fingertip amputations treated by stump revision and nail bed ablation were included.
  
  
  RESULTS
  The average length of the visible nail beds of the injured digits was 33.3% compared with the contralateral normal nail beds. The eponychial flap could lengthen the nail beds by an average of 32.4% of the length of the contralateral side. The mean follow-up was 26 months. Patients treated using the eponychial flap had greater pinch power of the reconstructed digits, higher satisfaction, and better aesthetic results when compared with patients receiving stump revision and nail bed ablation. There were no significant differences between two groups in sensation and Purdue dexterity test. Patient satisfaction was correlated with the reconstructed nail length.
  
  
  CONCLUSIONS
  The eponychial flap is a simple and safe technique that can restore the functional and aesthetic fingertip in selected distal phalanx amputations. The aesthetics, pinch power, and patient satisfaction are significantly better with fingernail preservation and elongation using the eponychial flap.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.
authors.forename: Hsin-Yu
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.
authors.forename: Chung-Chen
authors.initials: CC
authors.lastname: Hsu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.
authors.forename: Yu-Te
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.
authors.forename: Jiun-Ting
authors.initials: JT
authors.lastname: Yeh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan. Electronic address: lukechlin@gmail.com.
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery; D004954:Esthetics / Q000523:psychology*; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D050278:Finger Phalanges / Q000293:injuries / Q000294:innervation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000293:injuries / Q000601:surgery*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012677:Sensation; D013524:Surgical Flaps; D013997:Time Factors; D055815:Young Adult
keywords: Eponychial flap; Fingertip injuries; Nail complex; Nail injuries