A Case Report of Free Vascularized Nail Graft

A 19-year-old woman with a deformednail on her little finger for 10 years after trauma is reported. As a severe deformity from infection around the nail occurred frequently, we performed a free vascularized nail graft in order to reconstruct her nail. The third toe was chosen as a donor site, and the nail matrix and plate were sacrificed with two veins attached to the flap. Free skin graft was performed for the donor site. After the nail matrix and plate of the recipient site was resected, the flap were fixed and the two veins of the flap was anastomosed to a digital artery and a vein respectively. No complication due to the arterio-venous shunt after surgery was evident. The nail plate never fell off and the clinical result was excellent. Though arterio-venous anastomosis is not physiological, the venous flap is now recognized as an effective treatment. The procedure described in this paper is considered to be beneficial for cases in which nail reconstruction is necessary.