jovibon110@gmail.com
Networker
DX : Traumatic Laceration / Avulsion RT Thumb Distal Phalanx
Procedure: I & D , reconstruction thumb distal phalanx, and Thumb nail repair
Implant : Temporary Aluminum Nail
The procedure began with grossly debriding any contamination by utilizing the sponges available. We then conducted a Betadine wash of the open wound. All contaminants were able to be removed. We were dealing with a longitudinal laceration / avulsion that had clearly removed the nail traumatically the nail bed was lacerated from distal to proximal up into the germinal matrix. The radial pedicure flap was still with vascular perfusion. I proceeded first volarly to reapposed the fat pad and the volar portion of the distal phalanx. Was then able to reduce the nail bed sleeve over the exposed distal phalanx bone. At that time I also reattach the ulnar portion of the nail fold.
After successful reconstruction of the soft tissue sleeve was completed with the 3-0 proline I proceeded to repair the nailbed.
Laceration was linear dismally and with some Stellate appearance approximately towards the nail fold. I proceeded with a 5-0 Chromic Gut suture to reapposed the nailbed anatomically. A good sealed repair was successful.
At this juncture I irrigated the surgical site with normal saline 1 more time. I then utilized the zero form packet aluminum to fashion a nail which was sewn with 4-0 Prolene and gently placed into the nail fold to maintain this nail fold open.
Procedure: I & D , reconstruction thumb distal phalanx, and Thumb nail repair
Implant : Temporary Aluminum Nail
The procedure began with grossly debriding any contamination by utilizing the sponges available. We then conducted a Betadine wash of the open wound. All contaminants were able to be removed. We were dealing with a longitudinal laceration / avulsion that had clearly removed the nail traumatically the nail bed was lacerated from distal to proximal up into the germinal matrix. The radial pedicure flap was still with vascular perfusion. I proceeded first volarly to reapposed the fat pad and the volar portion of the distal phalanx. Was then able to reduce the nail bed sleeve over the exposed distal phalanx bone. At that time I also reattach the ulnar portion of the nail fold.
After successful reconstruction of the soft tissue sleeve was completed with the 3-0 proline I proceeded to repair the nailbed.
Laceration was linear dismally and with some Stellate appearance approximately towards the nail fold. I proceeded with a 5-0 Chromic Gut suture to reapposed the nailbed anatomically. A good sealed repair was successful.
At this juncture I irrigated the surgical site with normal saline 1 more time. I then utilized the zero form packet aluminum to fashion a nail which was sewn with 4-0 Prolene and gently placed into the nail fold to maintain this nail fold open.