Treatment of severe deformities of the toenails by the modified Zadik method with artificial skin.

A number of operations have been devised to treat ingrowing toenails and pincer nails, and they have given good aesthetic and functional results. However, there have been few reports of operations for the treatment of severe nail deformities caused by damage to the matrix of the nail by injury, or by inappropriate removal of the nail or intractable onychomycosis or cardiovascular or neurological disorders. In 1950, Zadik reported a radical technique for ingrown nails and pincer nails: after avulsion of the nail, the matrix was excised completely and the posterior nail wall was sutured to the nail bed as an advancement flap. We have treated 23 severe deformities other than ingrown nails and pincer nails in 14 patients by the modified Zadik method with artificial skin. As a result, symptoms including pain were alleviated in all patients. The nail plate did not regenerate, and no patient had aesthetic complaints.