Objective To investigate the effect of different ways of repairing the defect of fingernail bed. Methods Sixty patients with fingernail defect in our hospital from February 2017 to February 2018 were enrolled. The patients were divided into three groups according to the surgical procedure: toe nail flap repair, nail bed transplantation and fault bed nail transplantation. Toe nail flap repair group was treated with toe nail flap repair. The nail bed transplantation group was treated with anastomosed vascular nerve simple toenail bed transplantation. The fault bed nail transplantation group was treated with fault toenail bed transplantation. All three groups were followed up for 8 times. Months. The recovery of the finger function and the repair of the finger were evaluated at 3 months, 6 months and 8 months after operation, and the satisfaction of the three groups was evaluated. Results At 3 months, 6 months, and 8 months after operation, the functional scores of the toenail flap repair group were higher than those of the nail bed transplantation group and the fault bed group(P<0.05); 3 months and 6 after operation. There was no significant difference in the rate of excellent finger repair between the three groups (P>0.05). There was no significant difference in the satisfaction of the three groups(P>0.05). Conclusion The toe nail flap carries sensory nerves. Therefore, the treatment of fingernail bed defects with toe nail flap repair is beneficial to the recovery of surgical finger function.