Hamid, H., Mazeed, A., El Sayed, G., Saied, S. (2025). The Use of Composite Bone and Nail Bed Graft Combined with Cutaneous Flaps for Reconstruction of Fingertip Amputations. The Egyptian Journal of Plastic and Reconstructive Surgery, 49(3), 257-261. doi: 10.21608/ejprs.2025.444138
Hassan A Hamid; Ahmed Salah Mazeed; Gamal Youssef El Sayed; Samia M A Saied. "The Use of Composite Bone and Nail Bed Graft Combined with Cutaneous Flaps for Reconstruction of Fingertip Amputations". The Egyptian Journal of Plastic and Reconstructive Surgery, 49, 3, 2025, 257-261. doi: 10.21608/ejprs.2025.444138
Hamid, H., Mazeed, A., El Sayed, G., Saied, S. (2025). 'The Use of Composite Bone and Nail Bed Graft Combined with Cutaneous Flaps for Reconstruction of Fingertip Amputations', The Egyptian Journal of Plastic and Reconstructive Surgery, 49(3), pp. 257-261. doi: 10.21608/ejprs.2025.444138
Hamid, H., Mazeed, A., El Sayed, G., Saied, S. The Use of Composite Bone and Nail Bed Graft Combined with Cutaneous Flaps for Reconstruction of Fingertip Amputations. The Egyptian Journal of Plastic and Reconstructive Surgery, 2025; 49(3): 257-261. doi: 10.21608/ejprs.2025.444138
The Use of Composite Bone and Nail Bed Graft Combined with Cutaneous Flaps for Reconstruction of Fingertip Amputations
The Department of Plastic Surgery, Sohag Faculty of Medicine, Sohag University
Abstract
Background: The approach of using a composite graft consisting of bone and nail bed from the amputated part, along with a local skin flap, may offer a promising solution for managing fresh fingertip amputations to preserve its length and restore its shape. Objectives: This study aimed to evaluate the effectiveness of combining composite bone and nail bed grafts with different local skin flaps for fingertip reconstruction. Patients and Methods: This clinical study prospectively examined 16 patients, with an age ranging from 5 to 65 years, of both sexes, who had fingertip amputations at any level through the nail bed and distal phalanx, with the amputated part preserved. Results: The Flap used was cross finger in 15 patients (93.25%), and V-Y flap in 1 patient (6.75%). Flap viability was viable in 13 patients (81.25%), partial loss in 2 patients (12.5%) and flap loss in 1 patient. Nail bed survival was viable in 6 patients (37.5%), partial loss in 5 patients (31.25%), and total loss in 5 patients (31.25%). Bone graft survived in 12 patients (75%), partial loss in 2 patients (12.5%) and total loss in 2 patients (12.5%). Bone union was united in 12 patients (85.71%), and ununited in 2 patients (14.29%). Conclusions: The use of bone and nail bed as composite grafts combined with local and regional cutaneous flaps can effectively salvage fingertip amputations, particularly in patients where replantation is not feasible. Despite most favorable outcomes regarding flap viability and bone union, there were notable instances of nail bed loss.
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