Abstract
We performed fingernail reconstructions using a thin osteo-onychocutaneous venous flap from the 2nd-4th toes. This flap was modified as an onychocutaneous venous flap with a tiny bone under the nail. This series includes 5 cases, 2 patients with congenital nail defects and 3 posttraumatic patients. Four cases were scheduled for this flap operation in advance and one case that was scheduled for a vascularized osteo-onychocutaneous flap to the amputated thumb had been changed intraoperatively to a venous flap because of arteriosclerosis in the flap. As vascularity of the flap was unstable in 2 cases intraoperatively, intra-arterial infusion of anticoagulant and vasodilator was performed in these cases postoperatively. All flaps took.
The thin osteo-onychocutaneous venous flap is well indicated for reconstruction of nail defects or nail deformities in the finger that retains the length and volume of the fingertip. This flap procedure is the first choice for reconstruction of congenital nail defects. This flap technique is uncomplicated and safe. In cases in which vascularity of the conventional vascularized nail flap is not stable, this procedure may be used as the salvage technique.
