dr-machida.com 9th May 2002
IFFA meeting in San Francisco / September 2002

Eiichi Machida, M.D.

Corrective treatments of pincer nail deformity with super elastic wire.

1. Purpose
Pincer nail is a severe incurvature of the toenail, transverse rolling of the nail,often occurring in big toe, may hurt patients during long walks. Corrective treatment with super elastic wire was tried and evaluated.

2. Materials, methods and testing
Forty-two patients, thirty-four female, eight male, ages varied between eighteen to seventy-six. All nails were on the big toe. Five patients had a history of total removal of the nail at another hospital and the new nail grew into a pincer. Period of treatment is six months to three years.

Super elastic wire (SEW) is straight and made of a shape memory alloy. Three types of diameters, 0.5mm, 0.4mm, 0.35mm are used depending on the thickness and hardness of the nail. Two holes are made with needles at the distal free edge of the nail plate in the white portion which does not have sensation.  SEW is inserted in a inverted "U" shape. It took about five minutes for insertion  on each nail. The SEW was changed about once ever other month.

3. Results presented
In forty-one patients, pain disappeared between one to six days, and the pincer nail was corrected in six months to two years. One patient with a stone-like hard nail did not responded to this treatment.

4. Conclusions
Corrective treatment with SEW is a very effective and painless treatment for pincer nail. Two patients who had six months of treatment had mild recurrence again after one year. They desired SEW treatment again. SEW was chosen to be the first choice of treatment.