Total Nail Avulsion for Pincer Nail: Report of Two Cases

Abstract

Summary: Pincer nail is a common condition characterized by excessive transverse curvature of the nail that causes pain, cosmetic problems, and functional limitation. Surgical treatments include correction of the nail bed and distal phalanges, which have shown good outcomes but are difficult to perform in general clinics because of their high invasion. Conservative treatments require special devices, which may be difficult to keep on hand in general clinics. We report two cases of pincer nails successfully treated by total nail avulsion. The patient in case 1 is a 66-year-old woman. She had a pincer nail on her right third toe that was painful. Total nail avulsion was performed on the nail, and taping was performed after surgery. Three months later, a new flattened nail grew. The curvature index was improved from 2.43 to 1.10. The patient in case 2 is a 68-year-old woman. Total nail avulsion was performed on a pincer nail of the left second toe. Nineteen months later, the nail was flattened and she remained free from pain. The curvature index was improved from 3.62 to 1.32. In both cases, pain was soon relieved by total nail avulsion and there were no complications. Total nail avulsion does not require special devices, can be performed in a short time during outpatient treatment, and is relatively less invasive. It is also easily applied to small nails. Total nail avulsion is an effective treatment for pincer nails on the second and third toes. Future studies are needed to determine if it is equally effective for pincer nails on the first toe.