Surgical Management of Pincer Nail Deformity: A Simplified Technique.

INTRODUCTION

Pincer nail deformity (PND) involves excessive transverse nail plate over-curvature which pinches up distal nail bed and causes pain. Conventional surgical options are invasive with high complication risks. We treated pincer nails with a simplified, reproducible technique.

METHODS

Records of PND patients treated over 7 years with a simplified technique were retrospectively analyzed. After confirming the absence of any distal bony abnormality, lateral 1/5th-1/6th of the nail plate was avulsed on both sides, with chemical matricectomy of the lateral matrix horn. Thereafter, the distal one-third nail plate was avulsed to relieve traction on the pinched nail bed, not typically included in earlier techniques. This dual approach targeted both the causative (broad matrix) and resultant (distal traction) components of PND.

RESULTS

Records of 11 patients (15 great toenails) with symptomatic PND, without distal osteophytes, treated with this technique were analyzed. A mean follow-up of 28.6 ± 30.95 months with complete symptomatic relief and maintained nail flattening was seen. Patient-rated cosmetic outcomes were good (13), fair (3), or poor (1). Complications recorded were secondary infection (1), severe dystrophy (1), mild dystrophy (2), and malalignment (2).

CONCLUSION

This simplified surgical technique for PND is easy to learn and perform, and offers long-term effectiveness with minimal complications for PND without distal osteophytes.