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Nemoto H, Nakayama T, Seki Y, Hanai U, Imagawa K, Tsunoda Y, Komaba C, Kono T, Akamatsu T. Long-term results of nail correction with double wires for pincer nail deformity: A retrospective cohort study. J Plast Reconstr Aesthet Surg 2024; 88:487-492. [PMID: 38101262 DOI: 10.1016/j.bjps.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/16/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
There is no consensus on the best treatment for pincer nail deformity. We developed a novel procedure that uses double wires to treat pincer nail deformity on the great toe. This study aimed to describe this technique for pincer nail deformity treatment and present the long-term findings/observations. After injecting a local anesthetic, a mini router was used to make holes on both sides of the nail plate edge, and the wire was inserted in two places, one proximal and the other distal to the great toenail. The wire was removed when it moved to the tip of the great toe as the nail grew. Patients who underwent this method were evaluated retrospectively from 2014 to 2020. Patients with less than 24 months of follow-up were excluded. If pain occurred again, it was deemed as a recurrence. A total of 27 patients (36 toes, mean age: 69.5 years) were evaluated. In all cases, the pain disappeared 1 week after the procedure. In the correction period (mean 2.7 months), six toes had complications (nail break, four toes and nail hold pain, two toes), while recurrence occurred in four toes within 2 years. Curvature (nail tip height/width of nail tip × 100%) improved significantly up to 1-year post-procedure (37.7 ± 14.4%, p < 0.05) as compared to pre-correction (53.8 ± 24.7%). The procedure time was short (approximately 10 minutes), and the treatment was completed with a single procedure. In addition, the recurrence rate was low.
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Affiliation(s)
- Hitoshi Nemoto
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan; Department of Plastic Surgery, Yoh Memorial Hospital, Chiba, Chiba, Japan.
| | - Takahiro Nakayama
- Nakayama Plastic Surgery and Dermatology Clinic, Numazu, Shizuoka, Japan
| | - Yukio Seki
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Ushio Hanai
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kotaro Imagawa
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yotaro Tsunoda
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Chieko Komaba
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Taro Kono
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tadashi Akamatsu
- Department of Plastic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Saito M, Ikoma A, Fujikawa A, Tanaka K. Efficacy and safety of topical acetylcysteine combined with the use of an overcurvature-correcting device in patients with pincer nail deformity: a randomized, vehicle-controlled, investigator-blinded study. J DERMATOL TREAT 2023; 34:2248311. [PMID: 37599384 DOI: 10.1080/09546634.2023.2248311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND While pincer nails may be treated using overcurvature-correcting devices, it takes several months to achieve successful outcomes. Nail-softening drugs may reduce the treatment duration required. OBJECTIVE To evaluate the efficacy and safety of treatment with acetylcysteine (AC) gel added to an overcurvature-correcting device, and define the optimal AC concentration. METHODS In this investigator-blinded study, 70 patients with hallux pincer nail were fitted with an overcurvature-correcting device for 7 days and were randomly assigned to receive a single 24-h administration of a gel containing 10%, 20% or 30% AC or vehicle. Nail improvement was objectively evaluated by calculating the distal narrowed nail width (dNNW) ratio. RESULTS All three AC concentrations plus device showed earlier sustained improvement of pincer nails versus vehicle plus device. There was no observable correlation between AC concentration and effectiveness. No clinically problematic adverse events were observed at any AC concentration, and we recommended AC gel at a concentration of 10%. CONCLUSIONS By adding AC gel application to an overcurvature-correcting device, early and sustained reductions in transverse curvature were produced compared with using a device alone (vehicle control). The dNNW ratio used in this study was an appropriate objective index for evaluating therapeutic effects.
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Affiliation(s)
- Masataka Saito
- Medical Corporation Shinanokai Shinanozaka Clinic, Tokyo, Japan
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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Wang Y, Zhang J, Zhang N, Hu Y. A novel method to correct pincer nail deformity. J Cosmet Dermatol 2022; 21:6504-6505. [PMID: 35861582 DOI: 10.1111/jocd.15259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/12/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Yifan Wang
- Department of Foot and Ankle Surgery, The Second Hospital of Shandong University, Ji'nan, China
| | - Jiadong Zhang
- Department of Foot and Ankle Surgery, The Second Hospital of Shandong University, Ji'nan, China
| | - Ning Zhang
- Department of Foot and Ankle Surgery, The Second Hospital of Shandong University, Ji'nan, China
| | - Yong Hu
- Department of Foot and Ankle Surgery, The Second Hospital of Shandong University, Ji'nan, China
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Abstract
This article reviews the nomenclature, anatomic components, and physiologic growth involving the perionychium. Fingertip and nailbed injuries are commonly encountered problems in hand surgery. This article focuses primarily on dealing with chronic nailbed deformities following traumatic injury such as nonadherence, split nails, avulsion loss, and hook nails. Nail deformities secondary to pincer nail, mass effect, and pigmented lesions are reviewed as well. The underlying pathology and treatment options are examined for each deformity. The senior author highlights technical pearls and surgical planning for his preferred methods of reconstruction.
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Pincer Nail Deformity: Clinical Characteristics, Causes, and Managements. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2939850. [PMID: 32382542 PMCID: PMC7180426 DOI: 10.1155/2020/2939850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/27/2020] [Indexed: 11/18/2022]
Abstract
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.
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Noh SH, Na GH, Kim EJ, Park K. Significance of Surgery to Correct Anatomical Alterations in Pincer Nails. Ann Dermatol 2019; 31:59-65. [PMID: 33911540 PMCID: PMC7992702 DOI: 10.5021/ad.2019.31.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 08/08/2018] [Accepted: 09/19/2018] [Indexed: 11/08/2022] Open
Abstract
Background Pincer nail deformity and its causes can pose a therapeutic challenge. Ill-fitting shoes and subungual exostosis of the toes may be attributed to pincer nail formation. However, in some cases, the causes of pincer nail deformity could not be determined. The role of mechanobiology in nail configuration and deformities has rarely been considered. Objective The present study investigated the effectiveness of surgical procedures to correct pincer nail deformity, in terms of anatomical changes measured by radiographs. Methods Two surgical procedures, nail bed widening with matrixectomy or a dermal graft, were used on 30 nails in 20 patients with pincer deformity. Changes in the width, height, and curvature indices were assessed. Radiographs were obtained to evaluate the presence of osteophytes and measure the interphalangeal angle in terms of mechanobiology in nail configuration. Results Preoperative and postoperative assessment results revealed marked improvement objectively and subjectively. The mean width index was greater after surgery than that before surgery (84.4% vs. 64.8%). Both mean height and curvature indices were smaller after surgery than before preoperative (23.0% vs. 76.7% and 1.3% vs. 2.2%, respectively). Conclusion Nail bed widening with matrixectomy, which corrects anatomical alterations in pincer nails, is suggested to be suitable for patients with pincer nail deformity.
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Affiliation(s)
- Soo Hyeon Noh
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Ga Hye Na
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun Jung Kim
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Kun Park
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
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Triple Combination Therapy for Pincer Nail Deformity: Surgical Matricectomy, Thioglycolic Acid, and Anticonvex Sutures. Dermatol Surg 2017; 43:1474-1482. [DOI: 10.1097/dss.0000000000001252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Majeski C, Ritchie B, Giuffre M, Lauzon G. Pincer Nail Deformity Associated with Systemic Lupus Erythematosus. J Cutan Med Surg 2016. [DOI: 10.1177/120347540500900102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder with various systemic and cutaneous manifestations. Nail abnormalities, including onycholysis, red lunulae, pitting, and ridging, have been seen in patients with the disorder. To our knowledge, however, pincer nail deformity has yet to be reported coincident with the onset of SLE. Objective: We report a case of pincer nail deformity subsequent to the development of SLE and describe surgical treatment of the deformed nails. This is followed by a review of the literature. Conclusion: Acquired pincer nail is a dystrophy with numerous reported causative associations, including psoriasis, tumors of the nail apparatus, tinea ungium, ß-blocker usage, and now SLE. Pain from the resulting constriction can interfere greatly with daily activities and can be debilitating to the extent of requiring therapy.
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Affiliation(s)
- Candace Majeski
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Bruce Ritchie
- Division of Clinical Hematology, University of Alberta, Edmonton, Alberta, Canada
| | - Martin Giuffre
- Division of Plastic Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Gilles Lauzon
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
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Abstract
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.
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Anatomical characteristics and surgical treatments of pincer nail deformity. Arch Plast Surg 2015; 42:207-13. [PMID: 25798393 PMCID: PMC4366703 DOI: 10.5999/aps.2015.42.2.207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 12/04/2014] [Accepted: 12/23/2014] [Indexed: 11/08/2022] Open
Abstract
Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group (14.0°±3.6°) than in the control group (7.9°±3.0°) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity.
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Yabe T. Curvature index of pincer nail. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2013; 1:e49. [PMID: 25289244 PMCID: PMC4174051 DOI: 10.1097/gox.0b013e3182a9647a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 08/17/2013] [Indexed: 11/25/2022]
Abstract
Summary: Pincer nails are a common problem, and various treatments have been reported. However, there is no simple assessment of severity. We designed a curvature index for the nail plate to assess the severity of pincer nail. Measurement of the curvature index was as follows. The apparent width of the nail tip was defined as A, and the traced length of the nail tip was defined as B. The curvature index was defined as B divided by A (B/A). With this curvature index, it is easy to describe the severity of the pincer nail and to compare the improvement before and after treatment.
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Affiliation(s)
- Tetsuji Yabe
- Department of Plastic and Reconstructive Surgery, Ishikiri-Seiki Hospital, Higashi-Osaka City, Osaka, Japan
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12
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Tseng JTP, Ho WT, Hsu CH, Lin MH, Li CN, Lee WR. A Simple Therapeutic Approach to Pincer Nail Deformity Using a Memory Alloy: Measurement of Response. Dermatol Surg 2013; 39:398-405. [DOI: 10.1111/dsu.12094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Abstract
From 2006 to 2009 we treated nine cases (11 toes) with pincer nail deformity of the first toe, using phenol. There were 8 women and 1 man, age range 9-81 years (mean 51). They were followed up for 7-17 months (mean 12) and all reported improvement of the pincer nail deformity and disappearance of pain from the first toes. Only one woman complained of a recurrent pincer nail deformity eight months after the first treatment, and the procedure was repeated. The mechanism of improvement is contraction of the phenolised wound away from the lateral nail fold, which gradually stretches and flattens the nail bed. We conclude that this technique is a simple and effective treatment for pincer nail deformity.
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Affiliation(s)
- Akira Sugamata
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji city, Tokyo, Japan.
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Lee JI, Lee YB, Oh ST, Park HJ, Cho BK. A clinical study of 35 cases of pincer nails. Ann Dermatol 2011; 23:417-23. [PMID: 22148007 PMCID: PMC3229933 DOI: 10.5021/ad.2011.23.4.417] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 12/07/2010] [Accepted: 12/07/2010] [Indexed: 11/08/2022] Open
Abstract
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.
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Affiliation(s)
- Jae In Lee
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kosaka M, Asamura S, Wada Y, Kusada A, Nakagawa Y, Isogai N. Pincer nails treated using zigzag nail bed flap method: results of 71 toenails. Dermatol Surg 2010; 36:506-11. [PMID: 20187902 DOI: 10.1111/j.1524-4725.2010.01478.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In instances of pincer nail deformity, patients complain of pain associated with walking, wearing shoes, or light touching. Cosmetic concerns and difficulties in terms of nail clipping also arise. Achievement of a satisfactory nail form remains elusive. OBJECTIVE To introduce our original surgical procedure and present the satisfactory results. MATERIALS & METHODS The zigzag nail bed flap method was used on 71 toenails in 49 patients displaying pincer nails (11 male, 38 female; age range 12-88, mean, 48.6). This investigation evaluated 70 nails from the great toe and one nail from a second toe. RESULTS No postoperative complications, including pain, infection and conspicuous scars, were evident. The degree of improvement was determined objectively with the width and height indices, revealing the accuracy of this therapeutic measure. CONCLUSION The authors recommend surgical intervention consequent to the vicious cycle corresponding to anatomical abnormalities associated with the nail plate-nail bed-phalanges relationship. Therefore, these architectures should be treated in conjunction rather than singularly.
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Affiliation(s)
- Masaaki Kosaka
- Department of Plastic and Reconstructive Surgery, Kinki University School of Medicine, Osakasayama City, Osaka, Japan.
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Kosaka M, Kusuhara H, Mochizuki Y, Mori H, Isogai N. Morphologic study of normal, ingrown, and pincer nails. Dermatol Surg 2009; 36:31-8. [PMID: 19889164 DOI: 10.1111/j.1524-4725.2009.01361.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pincer nail has been confused with ingrown nail for decades. OBJECTIVE The objectives were to analyze the circumferential length of pincer nail and the relationship between nail deformity and the underlying distal phalangeal shape. METHODS The circumferential length of 53 pincer nails was determined at successive 5-mm intervals of the nail plate. Sixty great toes, including normal (n=20), ingrown (n=20), and pincer nails (n=20), were assessed with respect to body height, body weight, body mass index, nail height, nail width index, and nail height index. Nail angle and height of osteophyte were measured. RESULTS Despite the presence or absence of overcurvature, the circumferential length displayed nearly identical values across the proximal to distal range of the nail. In the pincer nail group, only the correlation between the width and height indices was statistically significant; 50%, 80%, and 100% of cases were confirmed based on osteophyte presence in normal, ingrown, and pincer nails. CONCLUSION The findings suggest that the mechanical cause may be associated with the over curved nail, which is affected by nail bed contraction. Results may support the hypothesis that an osteophyte of the distal phalanx may not be a cause of, but rather a result of, an overcurving deformity.
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Affiliation(s)
- Masaaki Kosaka
- Department of Plastic and Reconstructive Surgery, Kinki University School of Medicine, Osakasayama City, Osaka, Japan.
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Kosaka M, Morotomi T, Nitta M, Hashimoto T, Asamura S, Isogai N. A rare case of rapid progression from incurved nail to pincer nail. Dermatol Surg 2009; 35:1441-2. [PMID: 19737287 DOI: 10.1111/j.1524-4725.2009.01256.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Pincer nail is a rare deformity characterized by transverse overcurvature of the nail that increases distally. Many conservative and surgical treatment modalities have been recommended, but there is not a worldwide accepted technique for long lasting treatment of this deformity yet. PURPOSE A new surgical technique for the treatment of pincer nail deformity is described. MATERIAL AND METHOD In this procedure, after the osteophyte located on the dorsal surface of the distal phalanx is removed to provide a flat surface for the nail bed, the distal part of the nail bed is enlarged in a transverse direction by using a modified 5-flap z-plasty technique. Over 2 years, this technique has been performed on 15 toes in 8 patients. RESULTS In all patients, the deformity was eliminated successfully with no recurrence in 2 years of follow up. The growing nail turned back into its natural form and all clinical signs and symptoms of the pincer nail deformity were relieved. CONCLUSIONS Widening and flattening the nail bed provide a longlasting effective treatment of the pincer nail deformity with an excellent esthetic result. Pain and episodes of infection is relieved perfectly with this new technique.
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Affiliation(s)
- Mehmet Mutaf
- Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
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19
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Majeski C, Ritchie B, Giuffre M, Lauzon G. Pincer Nail Deformity Associated with Systemic Lupus Erythematosus. J Cutan Med Surg 2005; 9:2-5. [PMID: 16208437 DOI: 10.1007/s10227-005-0031-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disorder with various systemic and cutaneous manifestations. Nail abnormalities, including onycholysis, red lunulae, pitting, and ridging, have been seen in patients with the disorder. To our knowledge, however, pincer nail deformity has yet to be reported coincident with the onset of SLE. OBJECTIVE We report a case of pincer nail deformity subsequent to the development of SLE and describe surgical treatment of the deformed nails. This is followed by a review of the literature. CONCLUSION Acquired pincer nail is a dystrophy with numerous reported causative associations, including psoriasis, tumors of the nail apparatus, tinea ungium, ss-blocker usage, and now SLE. Pain from the resulting constriction can interfere greatly with daily activities and can be debilitating to the extent of requiring therapy.
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Affiliation(s)
- Candace Majeski
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
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20
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Ozawa T, Yabe T, Ohashi N, Harada T, Muraoka M, Ishii M. A splint for pincer nail surgery: a convenient splinting device made of an aspiration tube. Dermatol Surg 2005; 31:94-8. [PMID: 15720103 DOI: 10.1111/j.1524-4725.2005.31015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To treat pincer nail, both conservative therapy and surgical therapy have been reported. However, there is no consensus about the best method of treatment. OBJECTIVE The use of a splint prepared from an aspiration tube after pincer nail surgery is introduced. METHODS Pincer nail was treated by surgery with splinting in seven patients (nine toes). RESULTS Nine toes from seven patients were evaluated. The postoperative follow-up period ranged from 6 to 37 months (mean 17.7 months). An excellent result was obtained in eight toes, but ingrowth of the nail occurred in one toe. The cosmetic improvement was marked and satisfactory. CONCLUSION This splint is cheap and easy to make, can prevent contracture of the nail matrix and nail bed, can reduce pain, and allows direct observation of the nail bed because it is transparent. Thus, this technique seems to be convenient and useful.
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Affiliation(s)
- Toshiyuki Ozawa
- Department of Plastic and Reconstructive Surgery, Osaka City University, Graduate School of Medicine, Abeno, Osaka, Japan.
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