Pincer Nail Deformity: Clinical Characteristics, Causes, and Managements

Abstract

A pincer nail is a common nail deformity of toenails and is characterized by nail thickening and nail plate deformation. It often causes severe pain for patients. We perform a thorough literature review and an additional review of pertinent clinical cases, aiming to provide a comprehensive review of the etiology, pathogenesis, clinical classification, differential diagnosis, and treatment of pincer nail deformity (PND). Understanding the clinical characteristics and treatment progress of a pincer nail will provide clinicians with comprehensive and evidence-based information about PND, thus allowing the selection of an appropriate treatment according to the patient’s request and the clinical manifestations of PND, which should maximize patient satisfaction.

Common diseases of the nail: Diagnosis and therapy

“…Note that so-called traction osteophytes under the distal nail plate may occur. This needs to be considered and treated appropriately [72].…”

Häufige Nagelerkrankungen: Diagnostik und Therapie

“…Nagelkorrektursysteme, die auf der Nagelplatte mittels eines Composits geformt werden, können auch bei fortgeschrittenen Stadien noch erfolgreich sein [71]. Operative Behandlungen kommen ebenfalls zum Einsatz, wobei das mögliche Auftreten sogenannter Traktionsosteophyten unter der distalen Nagelplatte beachtet und behandelt werden muss [72].…”

How We Do It: Double Opposing Z-Plasties for Pincer Nail Deformity of the Finger

“…The excessive curvature of the distal nail plate exerts pressure on the lateral nail folds and may cause pain, inflammation, secondary infections, and cosmetic and functional impairment. 1,2…”

“…Various nonsurgical and surgical treatments have been proposed, but standardized treatment has not been established. 2 Nonsurgical treatments, including nail plate braces, repeated nail grinding, or topical uric acid/salicylic acid, require prolonged therapy and have high recurrence rates. Surgical treatments include ablating the lateral aspects of the nail matrix to produce a narrower nail plate that matches the transverse dimension of the distal nail bed.…”

“…To preserve a normal nail plate, surgery can widen the distal nailbed to match the width of the matrix. 1,2 Matrix-preserving surgery has been described for pincer nail deformity of the toenails but not for fingernails. 2–4…”