Ann Dermatol.  2011 Dec;23(Suppl 3):S299-S302. 10.5021/ad.2011.23.S3.S299.

Correction of Pincer Nail Deformity Using Dermal Grafting

• Nam HM
• Kim UK
• Park SD
• Kim JH
• Park K

• KMID: 2171856
• DOI: http://doi.org/10.5021/ad.2011.23.S3.S299

Abstract

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.

Keyword

Dermal grafting; Pincer nail deformity

MeSH Terms

Congenital Abnormalities
Female
Humans
Middle Aged
Nails
Thumb
Transplants

Figure

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  Fig. 1 Pincer nail of the left thumb with overcurvature of the right side of nail plate.

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  Fig. 2 (A) An oblique incision was made distal to the hyponychium in line with the most lateral aspect of the nail bed. (B) A tunnel for the graft was created between the nail bed and the underlying phalanx by a periosteal elevator. (C) Passing of the dermal graft (distal to proximal) through the tunnel by nylon 4-0 sutured to one end of the graft. (D) The graft was sutured to the skin proximally to hold it in the tunnel, and the hyponychial incision was closed with nylon 4-0.

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  Fig. 3 (A) Six weeks after surgery. (B) Five months after surgery.

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  Fig. 4 The graft was drawn into the tunnel more than 1 cm away from the nail matrix by nylon 4-0 sutured to its one end without incising the paronychial fold.

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