Using a Vertical Z-Plasty Eun Taik Son, MD, Min Sung Tak, MD., PhD - - PowerPoint PPT Presentation

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Using a Vertical Z-Plasty Eun Taik Son, MD, Min Sung Tak, MD., PhD - - PowerPoint PPT Presentation

Oct 27, 2023 42 likes •183 views

Correction of Pincer Nail Deformity Using a Vertical Z-Plasty Eun Taik Son, MD, Min Sung Tak, MD., PhD , Woo Jin Song, MD, 1 Plastic and Reconstructive Surgery, Soon Chun Hyang University Hospital, Seoul, South Korea Disclosure The

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Correction of Pincer Nail Deformity – Using a Vertical Z-Plasty Eun Taik Son, MD, Min Sung Tak, MD., PhD , Woo Jin Song, MD,

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Plastic and Reconstructive Surgery, Soon Chun Hyang University Hospital, Seoul, South Korea Disclosure The authors declare no competing financial interests.

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Purpose

  • Pincer nail deformity is an important

health problem that causes discomfort in daily life.

  • It is a deformity characterized by trans

verse overcurvature of the nail that inc reases distally.

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  • Recently several methods have been

reported for the treatment of pincer nail deformity, such as dermis graft, o r ADM(acellular dermal matrix) graft.

  • But these procedures have some

disadvantages, such as donor site morbidity, foreign body reaction or ext ra cost.

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  • In our procedure, using a vertical

z-plasty without additional graft material, we experienced excellent prognosis.

  • We report this simple procedure as a

new treatment modification

  • f

pincer nail deformity.

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Methods

  • From march 2010 to march 2012,

this technique has been performed on 6 toes in 5 patients.

  • We

designed vertically

  • riented

Z-plasty in apex of toe.

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  • The triangular medial flap(M flap) is

designed along to the over-curved nail bed.

  • And lateral flap(L flap) is designed

lateral portion of M flap.

  • After dissection, the triangular flaps

are transposed and redraped with deepithelization(Figure 1).

  • The nail bed flap was sutured with

5/0 nylon and artificial nail is inserte d

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Figure 1

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Results

  • In our procedure, the distal part of the

nail bed is elongated in a transverse direction by using a vertical z-plasty technique without additional matrix.

  • In all unilateral and bilateral cases,

the deformity was eliminated successfully with no recurrence in

  • ver 1 year of follow up.

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  • The growing nail turned back into its

natural form and all symptoms were relieved.(Figure 2)

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Figure 2

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Conclusions

  • Widening and flattening the nail bed

provide a long-lasting effective treatment of the pincer nail deformity and pain relief.

  • Our vertical Z-plasty method is found

to be simple and effective treatment modality for pincer nail deformity.

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References

  • 1. Mutaf M, Sunay M, Işk D. A new

surgical technique for the correction

  • f pincer nail deformity. Ann Plast

Surg.2007May;58(5):496-500.

  • 2. Baran R, Haneke E, Richert B.

Pincer nails: definition and surgical

  • treatment. DermatolSurg.2001Mar;27

(3):261-6.

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  • 3. Aksakal AB, Akar A, Erbil H,

Onder M. A new surgical therapeutic approach to pincer nail deformity. Dermatol Surg.2001Jan;27(1):55-7.

  • 4. Kosaka M, Asamura S, Wada Y,

Kusada A, Nakagawa Y, Isogai N. Pincer nails treated using zigzag nail bed flap method: results of 71

  • toenails. Dermatol Surg.2010Apr;36

(4):506-11.

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