Trimmed second toetip transfer for reconstruction of claw nail deformity of the fingers.

Claw nail deformities of the fingers have been repaired by many methods, but the results have been cosmetically unsatisfactory because of loss of the distal phalangeal bone and the short nail bed. We have employed a trimmed second toetip including the distal phalangeal bone and excluding the germinal matrix as a vascularised composite flap for two patients with claw nail deformity of the fingers. The advantages of this method are that the repaired nail regrows to normal size and has bilateral nail folds. We believe that, in comparison with other conventional local or island flaps, this composite flap is functionally and cosmetically ideal for the repair of claw nail deformities.