Noh Soo Hyeon, Na Ga Hye, Kim Eun Jung, Park Kun
Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea.
Ann Dermatol. 2019 Feb;31(1):59-65. doi: 10.5021/ad.2019.31.1.59. Epub 2019 Jan 2.
Pincer nail deformity and its causes can pose a therapeutic challenge. Ill-fitting shoes and subungual exostosis of the toes may be attributed to pincer nail formation. However, in some cases, the causes of pincer nail deformity could not be determined. The role of mechanobiology in nail configuration and deformities has rarely been considered.
The present study investigated the effectiveness of surgical procedures to correct pincer nail deformity, in terms of anatomical changes measured by radiographs.
Two surgical procedures, nail bed widening with matrixectomy or a dermal graft, were used on 30 nails in 20 patients with pincer deformity. Changes in the width, height, and curvature indices were assessed. Radiographs were obtained to evaluate the presence of osteophytes and measure the interphalangeal angle in terms of mechanobiology in nail configuration.
Preoperative and postoperative assessment results revealed marked improvement objectively and subjectively. The mean width index was greater after surgery than that before surgery (84.4% vs. 64.8%). Both mean height and curvature indices were smaller after surgery than before preoperative (23.0% vs. 76.7% and 1.3% vs. 2.2%, respectively).
Nail bed widening with matrixectomy, which corrects anatomical alterations in pincer nails, is suggested to be suitable for patients with pincer nail deformity.
钳形甲畸形及其病因可能带来治疗挑战。不合脚的鞋子和脚趾的甲下外生骨疣可能与钳形甲的形成有关。然而，在某些情况下，钳形甲畸形的病因无法确定。机械生物学在指甲形态和畸形中的作用很少被考虑。
本研究通过X线片测量的解剖学变化，探讨手术矫正钳形甲畸形的有效性。
对20例钳形甲畸形患者的30个指甲采用两种手术方法，即甲床加宽联合甲母质切除术或真皮移植术。评估宽度、高度和曲率指数的变化。拍摄X线片以评估骨赘的存在，并从指甲形态的机械生物学角度测量指间角度。
术前和术后评估结果显示，客观和主观上均有显著改善。术后平均宽度指数大于术前（84.4%对64.8%）。术后平均高度和曲率指数均小于术前（分别为23.0%对76.7%和1.3%对2.2%）。
甲床加宽联合甲母质切除术可矫正钳形甲的解剖学改变，建议适用于钳形甲畸形患者。
