case_images: PMC4347358_01
case_images: Amputation with significant soft tissue degloving immediately distal to the IP joint. The nature of the injury precluded microvascular repair, and an amputation-revision would have necessitated removing the IP joint (above). The amputated segment including nail plate, underlying nail bed, and pulp (below).
case_images: eplasty15e05_fig1.jpg
case_images: PMC4347358_01_eplasty15e05_fig1.jpg
case_images: F1
case_images: The avulsed segment of thumb included the nail bed, both sterile and germinal matrix, hyponychium as well as approximately 3 to 4 mm of distal phalanx (DP) (Fig 1).
case_images: Intraoperative X-ray showing approximately 2- to 3-mm loss of distal phalanx, and adequate reduction of the proximal phalanx fracture after pinning.
case_images: eplasty15e05_fig2.jpg
case_images: PMC4347358_01_eplasty15e05_fig2.jpg
case_images: F2
case_images: A closed reduction and pinning of the proximal phalanx fracture was accomplished under fluoroscopic guidance using two 0.045" K wires (Fig 2).
case_images: One-month postoperative result showing survival of composite graft with stable soft tissue coverage (left). A comparison of the repaired and noninjured thumb (right). A slight loss of length is noted, which is attributed to the loss of length of the distal phalanx and the fact that, at 1 month, the nail plate had not regrown fully.
case_images: eplasty15e05_fig3.jpg
case_images: PMC4347358_01_eplasty15e05_fig3.jpg
case_images: F3
case_images: At one month, the composite graft maintained stable soft tissue coverage and showed signs of nail plate regrowth (Fig 3).