Does the Nail Bed Regenerate?

Hand ◽  
2021 ◽  
pp. 155894472110643
Author(s):  
Jefferson Braga Silva ◽  
Gabriela A. Magnus ◽  
Valentina Stanham ◽  
Cecília G. Wolff ◽  
Carolina S. Aranchipe ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Middle Finger ◽  
Island Flap ◽  
Dominant Hand ◽  
Direct Flow ◽  
Nail Bed ◽  
Good Outcome ◽  
Crush Injuries ◽  
Trauma And Injury

Background: The regenerative potential of the nail bed after trauma remains controversial. Methods: We performed a retrospective review of 51 patients who underwent nail bed reconstruction with 2 techniques (direct flow island flap or a Tranquilli-Leali “Atasoy” flap) due to trauma involving the nail bed complex. These 2 flaps were used to support the loss of distal substance and to allow the regeneration of the nail bed. Outcomes were analyzed for at least 18 months. There were 34 men (66.7%), and the average age was 16.1 years. Most patients (56.9%) had crush injuries. The little (16) and index (14) fingers were the most affected. Twenty-seven were children (range: 4-11) with an average age of 7.4 ± 1.9 years. The middle finger was the most affected (29.2%). Results: The outcomes were good to excellent in 41 operated patients (80.4%). Hook nail was absent in 84.3% of the patients. Most patients (98%) did not develop necrosis. Children had an excellent/good outcome rate of 85.2%, while in adults, the rate was 75% of cases ( P = .485). Conclusion: The direct flow island flap is superior in terms of outcome, regardless of age, sex, affected finger, dominant hand, type of trauma, and injury zone. In cases where there was a correct reconstruction of the hyponychium, there was regeneration of the nail bed.

scholarly journals Nailbed repair and patient satisfaction in children

2010 ◽  
Vol 92 (6) ◽  
pp. 483-485 ◽  
Author(s):  
S Pearce ◽  
RJI Colville
Keyword(s):  
Patient Satisfaction ◽  
Complication Rate ◽  
Parent Satisfaction ◽  
Middle Finger ◽  
Outcome Data ◽  
General Anaesthetic ◽  
Nail Bed ◽  
Telephone Interviews ◽  
High Satisfaction Rate

INTRODUCTION We performed an audit to assess frequency of injury to the nail bed and outcomes after repair in a busy paedi-atric hand trauma clinic. SUBJECTS AND METHODS This retrospective study examines 46 consecutive nail bed repairs over a 6-month period. All notes were reviewed for patient demographics, details of the injury including the operation and aftercare. Telephone interviews were used to assess patient/parent satisfaction and complications. RESULTS The commonest mechanism of injury was trapping a finger in a door. The accident usually occurred indoors and most frequently affected the middle finger. The majority of repairs were carried out under general anaesthetic, by registrars, using absorbable synthetic sutures, within 24 h of the injury as a day-case. Outcome data with a minimum of 15 months follow-up, showed a high satisfaction rate (8.9/10) and low complication rate (7%), none of which required further surgery. There was a high failure rate of attendance in the follow-up clinic whilst the outcomes of those attending were good. CONCLUSIONS Outcomes and patient satisfaction were good with a low complication rate resulting in a change of practice in our unit to an ‘opt-in’ system for follow-up.

scholarly journals Reproducibility of the cold-induced vasodilation response in the human finger

2005 ◽  
Vol 98 (4) ◽  
pp. 1334-1340 ◽  
Author(s):  
Catherine O'Brien
Keyword(s):  
Blood Flow ◽  
Time Course ◽  
Cold Water ◽  
Temperature Response ◽  
Onset Time ◽  
Middle Finger ◽  
Warm Water ◽  
Finger Temperature ◽  
Nail Bed ◽  
Human Finger

Cold-induced vasodilation (CIVD) is a cyclic oscillation in blood flow that occurs in the extremities on cold exposure and that is likely associated with reduced risk of cold injury (e.g., frostbite) as well as improved manual dexterity and less pain while working in the cold. The CIVD response varies between individuals, but the within-subject reproducibility has not been adequately described. The purpose of this study was to quantify the within-subject variability in the CIVD response under standardized conditions. Twenty-one volunteers resting in a controlled environment (27°C) immersed the middle finger in warm water (42°C) for 15 min to standardize initial finger temperature and then in cold water (4°C; CWI) for 30 min, on five separate occasions. Skin temperature (Tf) and blood flow (laser-Doppler; expressed as percent change from warm-water peak) responses that describe CIVD were identified, including initial nadir reached during CWI, onset time of CIVD, initial apex during CIVD, time of that apex, and overall mean during CWI. Within-subject coefficient of variation for Tfacross the five tests for the nail bed and pad, respectively, were as follows: nadir, 9 and 21%; onset, 18 and 19%; apex, 12 and 17%; apex time, 23 and 24%; mean 10 and 15%. For blood flow, these values were as follows: nadir 52 and 64%; onset, 6 and 5%; apex, 33 and 31%; apex time 9 and 8%; and mean 43 and 34%. Greater variability was found in the temperature response of the finger pad than the nail bed, but for blood flow the variability was similar between locations. Variability in onset and apex time between sites was similar for both temperature and blood flow responses. The reproducibility of the time course of CIVD suggests this methodology may be of value for further studies examining the mechanism of the response.

scholarly journals Sensate Neurovascular Island Flap for Thumb Reconstruction

2021 ◽  
Vol 17 (1) ◽  
pp. 48-52
Author(s):  
Sungmi Jeon ◽  
Seung Min Kim ◽  
Sung Tack Kwon
Keyword(s):  
Postoperative Complications ◽  
Middle Finger ◽  
Venous Congestion ◽  
Island Flap ◽  
Middle Phalanx ◽  
Digital Nerve ◽  
Thumb Reconstruction ◽  
Ulnar Side ◽  
Aesthetic Appearance ◽  
Neuroma Formation

Thumb pulp defects require adequate reconstruction for satisfactory sensate function and aesthetic appearance. We report a reconstructive case using a sensate neurovascular island flap raised from the ulnar side of the middle finger for a tactile thumb pad defect. The flap was elevated as a modified version of the conventional heterodigital neurovascular island flap in order to restore thumb sensation without the “double-sensibility” phenomenon. The ulnar digital nerve of the flap was sectioned at the middle phalanx level of the donor digit and coaptated to the ulnar and radial digital nerves of the thumb through end-to-side and end-to-end neurorrhaphy. The remaining radial digital nerve of the donor finger was preserved, and the proximal end of the sectioned nerve was coaptated end-to-side to the radial digital nerve to prevent neuroma formation. No postoperative complications including venous congestion were observed. This technique is a relatively simple and reliable option for reconstructing thump pulp defects.

scholarly journals A Systematic Comparison of Perceptual Performance in Softness Discrimination with Different Fingers

2020 ◽  
Vol 82 (7) ◽  
pp. 3696-3709
Author(s):  
Aaron C. Zoeller ◽  
Knut Drewing
Keyword(s):  
Ring Finger ◽  
Middle Finger ◽  
Dominant Hand ◽  
Sensory Sensitivities ◽  
Motor Abilities ◽  
Soft Objects ◽  
Perceptual Performance ◽  
Improved Performance ◽  
Spontaneous Exploration ◽  
Little Finger

Abstract In studies investigating haptic softness perception, participants are typically instructed to explore soft objects by indenting them with their index finger. In contrast, performance with other fingers has rarely been investigated. We wondered which fingers are used in spontaneous exploration and if performance differences between fingers can explain spontaneous usage. In Experiment 1 participants discriminated the softness of two rubber stimuli with hardly any constraints on finger movements. Results indicate that humans use successive phases of different fingers and finger combinations during an exploration, preferring index, middle, and (to a lesser extent) ring finger. In Experiment 2 we compared discrimination thresholds between conditions, with participants using one of the four fingers of the dominant hand. Participants compared the softness of rubber stimuli in a two-interval forced choice discrimination task. Performance with index and middle finger was better as compared to ring and little finger, the little finger was the worst. In Experiment 3 we again compared discrimination thresholds, but participants were told to use constant peak force. Performance with the little finger was worst, whereas performance for the other fingers did not differ. We conclude that in spontaneous exploration the preference of combinations of index, middle, and partly ring finger seems to be well chosen, as indicated by improved performance with the spontaneously used fingers. Better performance seems to be based on both different motor abilities to produce force, mainly linked to using index and middle finger, and different sensory sensitivities, mainly linked to avoiding the little finger.

Epidemiology of Trigger Finger: Metabolic Syndrome as a New Perspective of Associated Disease

Hand ◽  
2019 ◽  
pp. 155894471986713
Author(s):  
Junot H. S. N. ◽  
Anderson Hertz A. F. L. ◽  
Gustavo Vasconcelos G. R. ◽  
Debora C. Esquerdo C. da Silveira ◽  
Paulo Nelson B. ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Ring Finger ◽  
Middle Finger ◽  
Trigger Finger ◽  
Scientific Article ◽  
Dominant Hand ◽  
Patients Âgés ◽  
New Perspective ◽  
The Right ◽  
Main Association

Objective: The aim of this study was to identify the main diseases related to trigger finger. Methods: A retrospective, observational study was performed with data obtained through a computerized record of 75 patients with trigger finger diagnosis between July 2011 and October 2015. The diagnosis of metabolic syndrome was performed following National Cholesterol Education Program Adult Treatment Panel III (2001). Results: Patients’ ages ranged from 50 to 84 years, with a mean age of 63 years. The ring finger was the most affected, followed by the middle finger, index finger, and little finger. Most had a grade 2 trigger finger classified by Green; the right hand involvement was more prevalent, as was the dominant hand. The incidence in women was twice as high as in men. Arterial hypertension, diabetes mellitus, and dyslipidemia were shown to be important associated diseases, but metabolic syndrome was the main association found. Conclusions: Metabolic syndrome in the group of patients studied in this scientific article seems to be the main associated disease.

A Nail Island Flap for Treatment of Macrodactyly

HAND ◽  
1983 ◽  
Vol os-15 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Lior Rosenberg ◽  
Ali Yanai ◽  
Dan Mahler
Keyword(s):  
Middle Finger ◽  
Island Flap ◽  
Secondary Intervention ◽  
Surgical Method ◽  
One Stage

A case of macrodactyly of the middle finger is presented. An easy and versatile one stage surgical method, using an Island axial nail flap is proposed. This method eliminated the need for secondary intervention.

scholarly journals The Management of Trigger Finger: A 5-Year Retrospective Review

2021 ◽  
Vol 4 (2) ◽  
Keyword(s):  
General Population ◽  
Retrospective Review ◽  
Flexor Tendon ◽  
Age Of Onset ◽  
Ring Finger ◽  
Trigger Finger ◽  
Dominant Hand ◽  
Increased Risk ◽  
Stenosing Tenosynovitis ◽  
A1 Pulley

Stenosing tenosynovitis, generally known as Trigger Finger (TF), is a common hand disorder characterized by pain and locking of the affected digit, which is often found on the dominant hand [1- 3]. This locking occurs when swelling or thickening of the flexor tendon restricts its ability to glide through the A1 pulley during flexion or extension [4, 5]. The general population has a two percent lifetime risk of developing trigger finger, with an average age of onset of 50 years [6, 7]. Women are affected up to six times more than men and diabetics have an increased risk of 10% [8, 9]. Although all digits are susceptible, evidence has shown the ring finger and thumb to be the most affected [10].

scholarly journals Recommendations on treatment of nail and fingertip injuries in children. Cases series and literature review

2016 ◽  
Vol 64 (3) ◽  
pp. 499 ◽  
Author(s):  
Enrique Vergara-Amador ◽  
Sergio Castillo Pérez ◽  
Wilson Tovar Cuellar
Keyword(s):  
Soft Tissue ◽  
Nail Plate ◽  
Germinal Matrix ◽  
Adequate Treatment ◽  
Nail Bed ◽  
Fingertip Injury ◽  
Anatomic Repair ◽  
Crush Injuries ◽  
Male Subjects ◽  
Matrix Damage

Introduction: Nail and fingertip injuries in children are very frequent and may range from a simple nail or fingertip injury to amputations.Objective: To present a series of cases with their clinical and demographic characteristics and to describe the current concepts for the treatment of these injuries.Materials and methods: A series of cases presenting fingertip injuries was analyzed for six months. Epidemiology of injuries is described and the current concepts of their treatment are reviewed.Results: 60% of the injuries analyzed in this study occurred in male subjects; 88% of patients suffered crush injuries, the nail was affected in 98% of the cases, sterile matrix damage was observed in 64% and germinal matrix damage was experienced in 34% of the cases. The soft tissue around the finger was affected in 40% of the cases and associated fractures were observed in 55% of the cases.Conclusion: Fingertip crush caused by closing doors was the most frequent injury, which implied a higher involvement of the nail. An adequate treatment focused on the anatomic repair of the nail bed, the relocation of the nail plate and, in some cases, the use of flaps to cover defects in the soft tissue is ideal for this type of injuries, and must be provided as fast as possible to avoid secondary deformities.

Spontaneous Zone III rupture of the flexor tendons of the ulnar three digits in elderly Korean farmers

2014 ◽  
Vol 40 (3) ◽  
pp. 281-286 ◽  
Author(s):  
G. J. Lee ◽  
S. Kwak ◽  
H. K. Kim ◽  
S. H. Ha ◽  
H. J. Lee ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Ring Finger ◽  
Rare Condition ◽  
Middle Finger ◽  
Dominant Hand ◽  
Level Of Evidence ◽  
Flexor Tendons ◽  
Flexor Tendon Rupture ◽  
Tendon Ruptures

Spontaneous flexor tendon rupture is a rare condition and the aetiology is not clear. We report 12 elderly Korean farmers with spontaneous flexor tendon ruptures. We found the rupture in the dominant hand in ten patients. A rupture in the little finger was found in all 12 patients (seven with both flexor tendons ruptured and five with only the profundus ruptured), in the ring finger in four patients (the profundus ruptured in all and both flexor tendons in two patients), and in the middle finger a partial rupture of the profundus in one patient. The tendons were ruptured close to the hook of the hamate. Repetitive friction between the flexor tendons and the hamate hook may cause the ruptures. The hamate hook was excised and the ruptured profundus tendons were reconstructed with tendon transfers with quite favourable functional recovery at follow-up of 1 to 2 years. The ruptured superficialis tendons were not reconstructed. Level of Evidence IV

scholarly journals Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajjad Rostamzadeh ◽  
Mahnaz Saremi ◽  
Shahram Vosoughi ◽  
Bruce Bradtmiller ◽  
Leila Janani ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Least Squares ◽  
Partial Least Squares ◽  
Middle Finger ◽  
Healthy Children ◽  
Dominant Hand ◽  
Hand Tools ◽  
Finger Length ◽  
Pls Analysis ◽  
Hand Length

Abstract Background The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7–18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength. Methods Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7–18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure. Results No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance. Conclusions These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.

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