Subscribe to RSS
DOI: 10.5999/aps.2015.42.2.207
Anatomical Characteristics and Surgical Treatments of Pincer Nail Deformity
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.
Publication History
Received: 13 September 2014
Accepted: 23 December 2014
Article published online:
05 May 2022
© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
REFERENCES
- 1 Cornelius 3rd CE, Shelley WB. Pincer nail syndrome. Arch Surg 1968; 96: 321-322
- 2 Plusje LG. Pincer nails: a new surgical treatment. Dermatol Surg 2001; 27: 41-43
- 3 Persichetti P, Simone P, Li Vecchi G. et al. Wedge excision of the nail fold in the treatment of ingrown toenail. Ann Plast Surg 2004; 52: 617-620
- 4 Kosaka M, Kusuhara H, Mochizuki Y. et al. Morphologic study of normal, ingrown, and pincer nails. Dermatol Surg 2010; 36: 31-38
- 5 Baran R, Haneke E, Richert B. Pincer nails: definition and surgical treatment. Dermatol Surg 2001; 27: 261-266
- 6 Greiner D, Schofer H, Milbradt R. Reversible transverse overcurvature of the nails (pincer nails) after treatment with a beta-blocker. J Am Acad Dermatol 1998; 39: 486-487
- 7 Higashi N. Pincer nail due to tinea unguium. Hifu 1990; 32: 40-44
- 8 el-Gammal S, Altmeyer P. Successful conservative therapy of pincer nail syndrome. Hautarzt 1993; 44: 535-537
- 9 Fraser AR. Orthonyx: theory and practice. Br J Chirop 1967; 32: 229-232
- 10 Maeda N, Mizuno N, Ichikawa K. Nail abrasion: a new treatment for ingrown toe-nails. J Dermatol 1990; 17: 746-749
- 11 Kosaka M, Kamiishi H. New strategy for the treatment and assessment of pincer nail. Plast Reconstr Surg 2003; 111: 2014-2019
- 12 Kosaka M, Asamura S, Wada Y. et al. Pincer nails treated using zigzag nail bed flap method: results of 71 toenails. Dermatol Surg 2010; 36: 506-511
- 13 Chapman RS. Letter: Overcurvature of the nails: an inherited disorder. Br J Dermatol 1973; 89: 317-318
- 14 DuVries HL. Diseases and deformities of the toenails. In: Inman VT. Surgery of the foot. St. Louis: CV Mosby; 1959: 204-222
- 15 Parrinello JF, Japour CJ, Dykyj D. Incurvated nail. Does the phalanx determine nail plate shape?. J Am Podiatr Med Assoc 1995; 85: 696-698
- 16 Moon HS, Son SJ, Park K. et al. A clinical study of efficacy of surgical management for pincer nails. Korean J Dermatol 2009; 47: 509-515
- 17 Suzuki K, Yagi I, Kondo M. Surgical treatment of pincer nail syndrome. Plast Reconstr Surg 1979; 63: 570-573
- 18 Hatoko M, Iioka H, Tanaka A. et al. Hard-palate mucosal graft in the management of severe pincer-nail deformity. Plast Reconstr Surg 2003; 112: 835-839
- 19 Brown RE, Zook EG, Williams J. Correction of pincer-nail deformity using dermal grafting. Plast Reconstr Surg 2000; 105: 1658-1661
- 20 Lee JI, Lee YB, Oh ST. et al. A clinical study of 35 cases of pincer nails. Ann Dermatol 2011; 23: 417-423