The authors report on 7 antenna procedures for the correction of a hook nail deformity. The operation performed in 6 cases (described by Atasoy et al., JHS 1983) involved a transverse incision beneath the distal nail bed, elevation of the nail bed with K-wires, and coverage of the pulp defect with a cross-finger flap. A V-Y advancement flap was used in 1 case to repair the soft-tissue void. Patients were examined at a mean follow-up of 3 years. All 7 patients had objective improvement in their deformity and were pleased with their results. However, some residual deformity remained in all cases including shortening of the nail, contour defect of the pulp, and flattening or residual curvature of the nail.
A hook nail is common following a traumatic amputation of the fingertip. Several procedures have been described to address this deformity, including ablation of the remaining nail bed tissue, free vascularized tissue transfer, bone grafting, and composite tissue grafting. Although the antenna procedure may result in improved nail cosmesis, the results are seldom perfect. A V-Y flap to cover the soft-tissue defect in the pulp, rather than a cross finger flap, can avoid scarring in the adjacent digit. However, tension in the pulp from tissue advancement and subsequent scarring may conceivably contribute to a recurrent deformity.
J Hand Surg