Nail Regeneration by Elongation of the Partially Destroyed Nail Bed

Patients with partially destroyed fingernails tend to hide them, and such patients often do not find help because fingernails are considered of little functional value. To improve the aesthetic appearance of such nails, a simple excision of the destroyed nail matrix can stimulate the growth of the residual healthy matrix and regenerate the nail. Prerequisite is a healthy nail residue of at least the lunula. An excision of an en bloc, crescent-shaped, full-thickness scar, 5 mm at its greatest width and extending from one lateral nail fold to the other, increases the length of the nail plate. Together with the matrix, the nail will grow about 4 mm distally. A second crescent-shaped excision 1 to 2 months later will further lengthen the nail until it has gained full length. Normal nail growth was achieved in 11 patients who had partially scarred nail beds after mycosis or trauma. (Plast. Reconstr. Surg. 111: 167, 2003.)