Nail Bed Repair and Fingertip Amputations — Anatomy, Flaps, and Functional Reconstruction

This episode reviews the core principles of nail bed injuries, fingertip trauma, and digital amputations, focusing on anatomy, repair technique, flap selection, and functional reconstruction.Topics include the germinal and sterile matrix, eponychium, hyponychium, nail growth, Beau’s lines, subungual hematoma management, and the modern approach to trephination when the nail plate is intact. The episode also reviews nail bed laceration repair, nail fold splinting, prevention of synechiae, nail bed grafting, hook nail deformity, pincer nail, and split nail complications.Fingertip reconstruction is discussed through secondary intention, full-thickness skin grafting, revision amputation, and local flap options including Atasoy, Kutler, Moberg, cross-finger, and thenar flaps. Emphasis is placed on sensibility, durability, exposed bone management, patient age, stiffness risk, and return-to-function goals.Additional topics include traction neurectomy, ray amputation, the Allen classification, Quadriga effect, lumbrical-plus finger, tic-tac-toe classification of mangled hand injuries, Krukenberg procedure, ectopic banking, and the repair sequence for replantation.Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons.Disclaimer:This podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordsnail bed repair, fingertip amputation, subungual hematoma, trephination, germinal matrix, sterile matrix, nail bed laceration, hook nail deformity, pincer nail, split nail, nail fold splint, synechiae nail fold, nail bed grafting, Atasoy flap, Kutler flap, Moberg flap, cross-finger flap, thenar flap, revision amputation, traction neurectomy, ray amputation, Quadriga effect, lumbrical plus finger, Allen fingertip classification, mangled hand tic tac toe classification, Krukenberg procedure, ectopic banking, digital replantation sequence