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. 2014 Mar 12;49(2):111-5.
doi: 10.1016/j.rboe.2014.02.005. eCollection 2014 Mar-Apr.

Trauma to the nail complex

Jefferson Braga Silva  1 , Samanta Gerhardt  2
Affiliations

Trauma to the nail complex

Jefferson Braga Silva et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: to analyze the results from surgical intervention to treat trauma of the nail complex.

Methods: we retrospectively reviewed a series of 94 consecutive patients with trauma of the nail complex who were treated between 2000 and 2009. In 42 patients, nail bed suturing was performed. In 27 patients, nail bed suturing was performed subsequent to osteosynthesis of the distal phalanx. In 15, immediate grafting was performed, and in 10, late-stage grafting of the nail bed. The growth, size and shape of the nail were evaluated in comparison with the contralateral finger. The results were obtained by summing scores and classifying them as good, fair or poor.

Results: the results were considered to be good particularly in the patients who underwent nail bed suturing or nail bed suturing with osteosynthesis of the distal phalanx. Patients who underwent immediate or late-stage nail grafting had poor results.

Conclusion: trauma of the nail complex without loss of substance presented better results than did deferred treatment for reconstruction of the nail complex.

Objetivo: analisar os resultados da intervenção cirúrgica do trauma do complexo ungueal.

Métodos: revisamos 94 pacientes consecutivos com trauma do complexo ungueal entre 2000 e 2009. Em 42 pacientes foi feita a sutura no leito ungueal. Em 27, a sutura do leito foi posterior à osteossíntese da falange distal. Em 15, foi feito enxerto imediato e em 10, enxerto tardio do leito ungueal. Foram avaliados o crescimento, o tamanho e a forma da unha comparados ao dedo contralateral. Os resultados foram obtidos com a adição de escores e a classificação deles como bom, regular e ruim.

Resultados: foram julgados como bons os pacientes que se submeteram principalmente a suturas do leito ungueal e sutura do leito e osteossíntese da falange distal. Pacientes submetidos a enxerto imediato e enxerto posterior da unha tiveram resultados ruins.

Conclusão: o trauma do complexo ungueal sem perda de substância apresentou melhores resultados comparado com a reconstrução do complexo ungueal.

Keywords: Finger injuries; Nail; Nail bed.

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Figures

Fig. 1
Fig. 1
Crushing of the thumb, with subungual hematoma.
Fig. 2
Fig. 2
Crushing of the thumb: volar view.
Fig. 3
Fig. 3
Nail bed injury.
Fig. 4
Fig. 4
Repair of the nail bed.
Fig. 5
Fig. 5
Final result.
Fig. 6
Fig. 6
Trauma of the nail complex.
Fig. 7
Fig. 7
Repair of the nail bed.
Fig. 8
Fig. 8
Silicone lamina.
Fig. 9
Fig. 9
Final result.
See this image and copyright information in PMC

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