Long-term follow-up visit report of the second toenail flap in the repair and reconstruction of overall hand skin degloving injury

Objective: To report the long-term follow-up visit results of the second toenail flap in the repair and reconstruction of overall hand skin degloving injury.Methods A total of 109 cases and 121 fingers of overall hand skin degloving injury patients have received the reconstruction by using the second toenail flap or dorsalis pedis flap for the repair and reconstruction.61 cases and 74 fingers were followed up for 2～8 years(4 years in average).Results The follow-up visits showed that the appearance of hand was all right,the toenails grew well,the finger pulps were plump,the sensory recovery S2~S4 of reconstruction finger and flap was achieved,the two point discrimination of 36 fingers reached 4~7 mm,the flexion function of 65 fingers were near normal,all fingers could accomplish writing and holding objects tasks,21 fingers could accomplish fine movements of picking up needles,the donor area showed syndromes in 4 cases,among which 2 cases showed indisposition,the ratio of syndromes was 6.5%.According to the tentative standard of thumb and finger reconstruction function access of the hand surgical branch of Chinese Medical Association,combined with the status of the foot donor area,45 cases and 52 fingers were excellent,13 cases and 6 fingers were good,3 cases and 6 fingers were medium,no bad cases,the ratio of choiceness was 95.1%.Conclusion The application of the second toenail flap in emergent repair and reconstruction of overall hand skin degloving injury could restore the nails and plump pulps.It could reconstruct the appearance and function of injured fingers to the highest degree.