Can You Reverse Pincher Nails
Plast Reconstr Surg Glob Open up. 2015 Feb; 3(2): e311.
A Novel Nonsurgical Treatment for Pincer Blast That Involves Mechanical Force Control
Received 2014 Sep nine; Accepted 2014 Sep xvi.
Summary:
We hypothesize that nails have an automated curvature feature and that their flat shape is maintained by the daily upward mechanical forces from the finger/toe pad. Thus, nail deformities, such as pincer nail, spoon nail, and koilonychias, may exist acquired by an imbalance between these forces and can be treated past controlling these forces. Here, nosotros study the case of a 55-twelvemonth-old man whose severe pincer nail was effectively treated past thinning the nail, which reduced the automatic curvature forcefulness. This is the get-go study to show that pincer nail tin can be treated past a nonsurgical method that reduces the automatic curvature force, thus obviating the need for surgery. This supports the notion that mechanical stimulus–based treatments take high therapeutic potential for nail deformities.
Our previous studies suggested that mechanical forces may influence nail configuration and could be involved in the development of nail deformities.1–iv This led to the hypothesis that nails have an automatic curvature feature and that their normal flat shape is maintained by the daily upward mechanical forces from the finger/toe pad. In other words, under normal weather condition, the upward daily mechanical forcefulness and the automatic curvature forcefulness are well balanced. However, an imbalance betwixt these two forces may cause blast deformation. For example, pincer nails may exist caused past the absenteeism of the upwards mechanical forces and/or by a genetically driven overstrong automatic curvature strength. Past contrast, koilonychias may occur when the upward mechanical force exceeds the automatic curvature force, thereby causing the blast to bend outward. This hypothesis then led u.s.a. to suggest that nail deformities tin be treated by improving the balance between automated nail curvature forcefulness and the upward mechanical forces from the finger/toe pad. The present instance report showed for the first time that indeed, pincer nail can be treated by reducing the automated curvature force, namely, past thinning the nails. This nonsurgical approach obviated the need for surgery.
CASE REPORT
For more than 10 years, a 55-year-old man was occasionally bothered by pain arising from the pincer nail of his left great toe. We proposed to thin the nail of his left peachy toe and provided him with a thorough explanation regarding the purpose and method of this treatment. He consented to participate. His nail configuration was measured by calculating the curve index, which is defined as (blast height/nail width) × 100 (%).one–3 Before treatment, the left curve index of his keen toe nail was 85.7% (Fig. 1), and his left great toe nail thickness was 1.4 mm. This thickness was thinned to 0.90 mm past using a nail grinder. 10 days afterwards, the smash showed signs of improvement (Fig. 2). The patient was followed up once in the following 2 weeks, and the new nail arising from growth was also thinned. Viii weeks afterward thinning commenced, the nail configuration had improved dramatically: the curve alphabetize was at present 54.ii% (Fig. 3). The patient no longer had whatever pain, and he was satisfied with the result of the handling.
Appearance before treatment.
X days after nail thinning, the smash showed signs of improvement.
Advent 2 months later on nail thinning commenced.
Give-and-take
To treat pincer nail, various surgicalfive–eight and bourgeois measures9,10 take been classically used. The surgical procedures aim to remove the nail matrix cells but have several disadvantages, namely, the surgery tin can be complex, the patient may feel pain after surgery, the surgical procedure can exist time consuming, local anesthesia is needed during the operation, and corrective deformity can ensue. The bourgeois treatments involve the use of an elastic wire11 or a plastic device12,thirteen and aim to reinforce the upward daily mechanical force. Although the latter treatments are relatively noninvasive, they demand frequent care, and the recurrence charge per unit is high.
We propose the following treatment principle for pincer smash. It is less invasive than surgery and is based on the hypothesis that is detailed in the introductory paragraph. Thus, pincer nail could be treated (or prevented) either past reinforcing the upward daily mechanical force or by reducing the automatic curvature force of the nail or both. To reinforce the upwardly daily mechanical forcefulness, the classic bourgeois measures described above can exist used. In addition, massage, a stimulatory car, or changing the walking mode so that more pressure is placed on the toe pad may be useful. To reduce the automatic curvature force of the nail, the boom could be softened or thinned by applying an external preparation. This would serve to reduce both the hardness and thickness of the nail.
In the present case, nail thinning was used because our cumulative experience suggests that thick nails tend to bear witness strong nail curvature, and the toe nails of our patient were quite thick compared to what is usually seen in the toe nails of healthy convalescent adults (approximately 0.8 mm).one The thinning of the patient's pincer boom dramatically improved its excessive curvature subsequently 2 months. Complications were not observed. This result reinforced the validity of our hypothesis. It too suggested that mechanical stimulus-control treatments may have high therapeutic potential for smash deformities. Further studies are needed to decide the long-term outcomes of this approach and to institute an optimal and effective thinning method.
CONCLUSION
This case written report showed that pincer nail can be treated by thinning the nail. This result suggested that nail deformities may be treated by improving the balance betwixt automatic nail curvature force and the upward mechanical forces from the finger/toe pad.
Footnotes
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Accuse was paid for by Nippon Medical Schoolhouse.
REFERENCES
1. Sano H, Ichioka S. Influence of mechanical forces as a part of nail configuration. Dermatology. 2012;225:210–214. [PubMed] [Google Scholar]
two. Sano H, Ogawa R. Function of mechanical forces in hand blast configuration asymmetry in hemiplegia: an analysis of 400 thumb nails. Dermatology. 2013;226:315–318. [PubMed] [Google Scholar]
3. Sano H, Shionoya K, Ogawa R. Bear upon of mechanical forces on finger nail curvature: an assay of the impact of dissimilar occupations on 332 finger nails. Dermatol Surg. 2014;40:441–445. [PubMed] [Google Scholar]
4. Sano H, Ogawa R. Clinical evidence for the relationship betwixt nail configuration and mechanical forces. Plast Reconstr Surg Glob Open up. 2014;two:e115. [PMC gratis article] [PubMed] [Google Scholar]
5. Plusjé LG. Pincer nails: a new surgical treatment. Dermatol Surg. 2001;27:41–43. [PubMed] [Google Scholar]
vi. Aksakal AB, Akar A, Erbil H, et al. A new surgical therapeutic approach to pincer nail deformity. Dermatol Surg. 2001;27:55–57. [PubMed] [Google Scholar]
7. Baran R, Haneke E, Richert B. Pincer nails: definition and surgical treatment. Dermatol Surg. 2001;27:261–266. [PubMed] [Google Scholar]
8. Zook EG, Chalekson CP, Brownish RE, et al. Correction of pincer-nail deformities with autograft or homograft dermis: modified surgical technique. J Hand Surg [Am] 2005;30:400–403. [PubMed] [Google Scholar]
ix. Effendy I, Ossowski B, Happle R. Pincer nail: conservative treatment by attachment of plastic braces. Hautarzt. 1993;44:800–802. [PubMed] [Google Scholar]
10. Kim KD, Sim WY. Surgical pearl: nail plate separation and splint fixation—a new noninvasive treatment for pincer nails. J Am Acad Dermatol. 2003;48:791–792. [PubMed] [Google Scholar]
11. Moriue T, Yoneda Chiliad, Moriue J, et al. A simple therapeutic strategy with super rubberband wire for ingrown toenails. Dermatol Surg. 2008;34:1729–1732. [PubMed] [Google Scholar]
12. Harrer J, Schöffl V, Hohenberger Due west, et al. Treatment of ingrown toenails using a new conservative method: a prospective study comparing brace treatment with Emmert'south process. J Am Podiatr Med Assoc. 2005;95:542–549. [PubMed] [Google Scholar]
xiii. Di Chiacchio N, Kadunc BV, Trindade de Almeida AR, et al. Handling of transverse overcurvature of the smash with a plastic device: measurement of response. J Am Acad Dermatol. 2006;55:1081–1084. [PubMed] [Google Scholar]
Articles from Plastic and Reconstructive Surgery Global Open are provided here courtesy of Wolters Kluwer Health
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350317/
Posted by: hernandezmeare1990.blogspot.com
0 Response to "Can You Reverse Pincher Nails"
Post a Comment