Fingertip injuries and thumb amputations Flashcards
Normal growth rate of finger nails?
2-5mm/month, 6 months for total regrowth
After nail avulsion, how long time does it take for the nail to appear in the nail fold?
2 months
How long time is nail growth stopped after injurie
3 weeks
Then quick growth 60d, slow growth 30d with a headline that appears between)
Difference between perinychium and paronychium?
peri - over the nail plate (cuticle, pros fold, lat fold)
pro - under (sterile fertile matrix, hiponychium, distal groove)
Where starts germinal matrix?
-0,5 to + 1,5mm from extensor tendon insertion
What function serves the sterile matrix?
Nail plate adhesion
What function serves the hyponychium?
Distal part of of nail bed where the nail plate looses its adhesion. Mechanical barrier with immunologic function.
Median Canaliform Dystrophy of Heller is?
Self-inflicted trauma to the nail
4 volar homodigital flaps
Segmuller flap (to midline, both sides)
Homodigital reverse flap
Venkataswami flap (over midline, only one side)
V-Y
2 Heterodigital flaps
Cross finger
Littler flap
(Thenar flap)
5 Thumb flaps
Moberg/Elliot
V-Y
Kite flap
Dorso-ulnar
Great toe free pulp flap
Classification of thumb level of amputation
Lister 1985
a. IPj (acceptable length poor tissue coverage)
b. P1 (questionable length)
c. Total: metacarpal lvl, preserved basal joint
d. Total: loss of basal joint
Lister A thumb amputation
- Eponychium flap (pull back eponychium to expose the nail)
- great to -> thumb
- trimmed great to for cosmetic concerns
Lister B treatment
Intact MCPj
- bone lengthening
- on top plasty (from amputated index)
- osteocutaneous radialis flap (difficult, resorption)
- toe transfer
Lister C treatment
Toe transfer only option
