A new surgical technique for the correction of pincer nail deformity

Reconstruction of a nail bed with double-layer artificial dermis for a pincer nail: A case report and literature review

Background

A pincer nail (PN) is a type of nail deformity. Although it is a minor ailment, it can cause intractable pain, affecting daily work and life. Currently, there is no standard invention for PN. The main purpose of treatment is to correct the curvature of the nail, so we apply double-layer artificial dermis (DLAD), a novel treatment, for PN according to this aim.

Case presentation

A 40-year-old man suffering from PN was treated with DLAD. After 1 year of follow-up, the patient's great toenail plate of the right foot was completely grown out. His pain was relieved, and the curvature of the toenail was corrected.

Conclusion

The innovative method of using DLAD to fill the ingrown nail bed not only solves the problem of recurrent pincer nail deformity but also restores the original appearance of the toenail. It suggested that this simple procedure can be widely applied in clinical practice.

Pincer Nail Deformity: Clinical Characteristics, Causes, and Managements

A pincer nail is a common nail deformity of toenails and is characterized by nail thickening and nail plate deformation. It often causes severe pain for patients. We perform a thorough literature review and an additional review of pertinent clinical cases, aiming to provide a comprehensive review of the etiology, pathogenesis, clinical classification, differential diagnosis, and treatment of pincer nail deformity (PND). Understanding the clinical characteristics and treatment progress of a pincer nail will provide clinicians with comprehensive and evidence-based information about PND, thus allowing the selection of an appropriate treatment according to the patient's request and the clinical manifestations of PND, which should maximize patient satisfaction.

Correction of pincer nail deformities using a modified double Z-plasty

BACKGROUND

Pincer nail is a deformity characterized by excessive transverse curvature of the nail plate that increases distally for which many conservative and surgical corrective modalities have been recommended.

OBJECTIVE

The purpose of this study is to investigate the outcomes and safety of modified double Z-plasty in the management of symptomatic pincer nail.

MATERIALS AND METHODS

Modified double Z-plasty has been performed on 20 great toes in 12 patients from January 2008 to December 2013. The mean age of patients was 43 (range: 20-65) years. Three men and 9 women were enrolled. Visual analogue scale (VAS) score for pain, transverse angle, and width indices were investigated at the initial and the last follow-up. The average follow-up period was 2.4 years.

RESULTS

All parameters showed significant improvement after surgery. Between the initial and last follow-up, the mean VAS score fell from 7.4 to 0.3, the mean transverse angle improved from 50 to 166°, and the mean width index improved from 65.4% to 97%. In all patients, the deformity was successfully eliminated with no recurrences. No complications were identified.

CONCLUSION

Modified double Z-plasty provides a long-standing effective treatment for pincer nail deformity with an excellent esthetic result.

Congenital nail abnormalities: a review of the literature

Congenital nail abnormalities (CNAs) are rare conditions in which the nail tissue appears abnormal compared with the fingers and the toes. They usually present accompanying deformities and disorders. Our purpose was to review the current literature on the clinical aspects of CNA. We reviewed the literature to evaluate peer-reviewed articles on the topic. Detailed reports have characterized many types of CNA. In this article, we provide a review of the literature based on the current understanding of CNAs and the clinical varieties thereof.

A clinical study of 35 cases of pincer nails

BACKGROUND

Pincer nail is a nail deformity characterized by transverse overcurvature of the nail plate. Pincer nail can affect a patient's quality of life due to its chronic, recurrent course; however, there have been no clinical studies on the pincer nail condition in Korean patients.

OBJECTIVE

The purpose of this study was to characterize the clinical findings and treatment of pincer nail. In addition, possible etiological factors were considered, and treatment efficacy was evaluated.

METHODS

The medical records and clinical photographs of 35 patients (12 males, 23 females) who were diagnosed with pincer nail between August 1, 2005 and July 31, 2009 were studied.

RESULTS

Patient age ranged from 10 to 77 (52.09±17.26) years, and there was a predominance of female (23 out of 35 patients, F:M=2:1). The mean duration of the disorder was 7.45 years (range 0.25~40); 85% had pincer nail for at least 1 year. In addition, 40% had a history of previous treatment and recurrence. There were 82.8% patients with the common type of pincer nails. The most commonly involved nails were both great toenails. Among 35 patients, nail grinding was started in 30 patients, and 25 patients showed clinical improvement with nail grinding. The width index increased and the height index decreased after treatment. The mean follow up period was 8.42 months (range 1~27), and 7 patients showed recurrence after 8.8 months (range 2~20). Among 35 patients, 5 patients were treated with nail extraction with matricectomy, and the symptoms resolved immediately. The mean follow up period was 7.6 months (range 0~19), and recurrence was not observed. Onychomycosis was also present in 37.1% of patients, and itraconazole pulse therapy for 3 months was added.

CONCLUSION

The results of this study demonstrate the clinical features of pincer nail in Korean patients. The findings show that the common type of pincer nail was most common, and nail grinding as a conservative treatment greatly improved pincer nails despite a risk of recurrence. When onychomycosis was also present, oral antifungal therapy added to nail grinding resulted in a more rapid change in nail thickness and clinical improvement.