This randomized controlled trial aimed to compare infection rates, pain levels, and functional and aesthetic outcomes of nail bed repair with versus without nail plate replacement. Sixty patients with acute nail bed injuries were randomized into two equal groups: repair with nail plate and repair without nail plate. Standardized microsurgical techniques were used. Patients were evaluated at multiple postoperative intervals for infection, pain (VAS), nail appearance, range of motion, and patient satisfaction. The nail plate group showed lower infection rates, less pain at selected time points, and better cosmetic results. Early postoperative range of motion limitation was more frequent in the non-plate group but not significant at final follow-up. Nail plate replacement during nail bed repair reduces infection risk and pain while enhancing cosmetic outcomes. It may be considered a standard step in nail bed reconstruction when feasible. Therapeutic, Level 1
Elmi et al. (Sun,) studied this question.