Correction of crooked nail deformity by modified osteoplastic reconstruction

To correct crooked nail deformity, which results from the partial loss of t he distal phalanx, soft-tissue restoration alone is usually not enough to r estore the length and shape of the nail structure. The authors treated 10 c rooked nail fingertips by modified osteoplastic reconstruction, which inclu ded the elevation of the dorsally based volar skin flap and an iliac bone g raft covered by an adequate skin flap. During the postoperative follow-up, the nail straightened, although not to the preinjury extent, along the rest ored distal phalanx with bony support. The authors' osteoplastic reconstruc tion, which involves the enhancement of the fingertips with composite tissu es, presents a practical method for the correction of crooked nail deformit y.