dr-machida.com@12 September,2002

Slide 1 (title)

Corrective treatments of pincer nail deformity with super elastic wire.

Slide 1
This is the first time this study of using@super elastic wire to treat pincer nail deformities is being presented in English.

Slide  2 (support)
Slide 2
Tama medical company has financially supported this study.

Slide 3 (pincer nail)
Slide 3
Pincer nail is a severe incurvature of the toenail, a transverse rolling of the nail, it often occurs in the big toe. Pincer nails make daily life uncomfortable, often causing severe pain.

Slide 4 (se-wire) Slide 4
S.E. wire is made of a shape memory alloy. It is straight and extremely flexible.

Slide 5 (movie)  Slide 5
Treatment with S.E. wire begins with the puncturing of two holes. The punctures are made with injection needles through the distal free edge of the nail plate. S.E. wire is inserted in an inverted "U" shape so that it is stitched into the nail. S.E. wire treatment takes about five minutes for insertion. The S.E. wire should be changed about once every other month. QuickTime movie (1.4MB)

Slide 6 (patients) Slide 6
I have selected 42 patients, who were the most difficult cases for this study. Five patients had a previous history of total removal of the nail and the new nail grew into a pincer. Period of treatment with S.E. wire was six months to three years.

Slide 7 (results / Monkey family)  Slide 7
This treatment has already helped thousands of patients with incurved and ingrown toenails in Japan. The success of this treatment has been astounding. The following slides will detail the success of this procedure.

Slide 8 (results) Slide 8
In 98% of the patients studied, pain disappeared between one and six days, and the nail was corrected in six months to two years. One patient with a stone-like hard nail did not respond to this treatment.

Slide  9 (71y/o patient) Slide 9
This patient was untreatable by any other method. After 15 months of treatment with SE wire the nail was completely corrected, and there was no reoccurrence of nail deformity.

Slide 10 (41y/o patient) Slide 10
This middle age female with a pincer nail had surgery 3 times previously. She was frustrated with the reoccurrence of this problem. Silver nitrate and cotton packing were used to decrease inflammation. This patient had great success using S.E. wire treatment.

Slide 11 (18y/o patient) Slide 11
Soft nails respond very well to super elastic wire. SE wire works by spreading the tip of the nail. As the nail continues to grow, the nail bed and the proximal area of the nail are corrected by the upward force provided in the wire.

Slide 12 (28y/o patient) Slide 12
Even nails with deformity of the distal phalanx can be corrected with super elastic wire.

Slide 13 (difficulties / happy monkey) Slide 13
There are some difficulties with this treatment.

Slide 14 (tube) Slide 14
For SE wire treatment, the nail must hang a minimum of 2mm over the tip of the toe. In case the nail is trimmed too short, cotton packing or flexible tube splinting are used for one to two months to ease pain while waiting for new nail growth.

Slide 15 (breakage) Slide 15
The nail plate may break with this treatment. Breakage is handled by trimming the nail and waiting for new nail growth. Then a thinner wire that applies less corrective force is used.

Slide 16 (hard nail) Slide 16
For hard nails, multiple S.E. wires are used. Abrasion with a motor grinder can be used in order to reduce the thickness of the nail. Urea ointment, for softening of the nail plate may be needed.

Slide 17 (recurrence) Slide 17
After correction some people may have recurrence. But, all of my patients request S.E. Wire treatment again.

Slide 18 (orthodontics) Slide 18
Super elastic alloy and shape memory alloy are used in dentistry and are completely safe to use for this corrective treatment.
I have operated on hundreds of ingrown toenails in my career. After I started using treatment with super elastic wire, I haven't performed matrixectomy or phenolization on any patient.

Slide 19 (FDA) Slide 19
For more information please visit dr-machida.com or tama- medical.com. Thank you for your time.