The Effectiveness of Surgical Correction of Pincer Nails Using Nail Bed Flap and Bilateral Partial Matrixectomy, with or without Osteophyte Removal

Park, Sang Hyun; Kim, Eun Jung; Park, Kun

Abstract

BACKGROUND
A pincer nail is characterized by the presence of an excessively curved and distorted nail across the transverse dimension. A multitude of therapeutic modalities have been implemented to treat this condition with limited efficacy.
OBJECTIVE
We sought to evaluate the efficacy of surgery for pincer nail deformity with the use of the nail bed flap and bilateral partial matrixectomy, with or without osteophyte removal.
METHODS
Nine patients (four patients: both great toe nails, five patients: single toe nail) with pincer nail deformities were treated with nail bed flap and bilateral partial matrixectomy, with or without osteophyte removal. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail tip). Subjective assessment was evaluated through patient global assessment (PGA) and use of the pain visual analogue scale as declared by patients. In addition, wound complications and recurrences were described.
RESULTS
The width index and height index were improved (width index: 85.5%-->97%, height index: 54.3%-->3.4%). All of the patients claimed 'good' or higher in the PGA score. Relief of pain was shown in 100% of the cases. There was no recurrence during a 6- to 20-month period (mean time: 11.8 months) and no complications.
CONCLUSION
Nail bed flap and bilateral partial matrixectomy with or without osteophyte removal as a surgical approach might be an effective and curative method of treatment for pincer nail deformity.