Special Topic∙External Birth Defects·Clinical Research Article
The lateral nail fold plasty in duplicated thumbs with a common nail
Weiyang Gao, Jian Ding, Anyuan Wang, Zongwei Zhou, Long Wang
Published 2020-01-25
Cite as Chin J Plast Surg, 2020, 36(1): 35-40. DOI: 10.3760/cma.j.issn.1009-4598.2020.01.007
Abstract
ObjectiveIn this study, a new surgical technique was developed to reconstruct the lateral nail fold in the duplicated thumbs with a common nail and postoperative outcomes were evaluated.
MethodsFrom December 2012 to October 2015, sixteen duplicated thumbs with a common nail were treated in our hospital using a flap from resected finger pulp which did not include the nail and phalanx. Unilateral inverting suture was performed between the flap and nail bed to reconstruct the lateral nail fold and nail groove. Postoperative outcomes were evaluated by Wang-Gao scoring system (total 12).
ResultsThe follow-up period ranged from 10 to 45 months. The reconstructed nails were smooth and had a natural lunula, and the nail width was about 80%-100% of their normal sides. There was a right angle between the nail epithelium and lateral nail fold in four cases, and an acute angle in two cases. The reconstructed nails were asymmetrical in these thumbs. One patient showed a hypertrophy in the lateral nail fold. The reconstructed nails were evaluated by Wang-Gao scoring system: 10 in 2 cases, 11 in 4 and 12 in 10. All the cases had excellent results.
ConclusionsThe nail width usually is more than 80% of the normal sides in the radial polydactyly with a common nail. The surgical technique can reconstruct a natural lateral nail fold and nail groove, and avoid the nail deformity caused by the Bilhaut-Cloquet procedure.
Key words:
Congenital deformity; Thumb polydactyly; Surgical flap; Nail
Contributor Information
Weiyang Gao
Department of Orthopaedics, Division of Hand and Plastic Surgery, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University, Key Laboratory of Orthopaedics of Zhejiang Province, Key Medical Supporting Disciplines of Microsurgery of Zhejiang Province, Wenzhou 325027, China
Jian Ding
Anyuan Wang
Zongwei Zhou
Long Wang
