A boy, aged 16 years, suffered an injury two years before I saw him which resulted in the loss of the nail from the left thumb. In the interval there had been ineffective attempts at restoration. At the time he was examined, there was no longer any nail growth; at about the level of the lunula there was a disintegrating mass, while toward the point of the thumb the nail bed had given place to cicatrized tissues, warped and folded in leaves. There was considerable pain.
It was evident, especially in view of the failure of previous interventions, that the problem was one of replacement—of introducing a nail that would grow. From this consideration two questions arose: Could nail substance transferred to an area in which growth had ceased be expected to grow? If so, from what area should it be taken, and what would be the subsequent history in