PMC9869056_01
Preoperative appearance of affected great toenails at different angles (A,B).
fsurg-09-1047171-g001.jpg
PMC9869056_01_fsurg-09-1047171-g001.jpg
F1
Physical examination revealed a pincer-like deformity (Figures 1A,B) of the right great toenail with peri-nail redness and swelling without pus exudation.
Appearance of double-layer artificial dermis.
fsurg-09-1047171-g002.jpg
PMC9869056_01_fsurg-09-1047171-g002.jpg
F2
After that, the DLAD (Figure 2) from Lando, Shenzhen was soaked in saline for 5 min, and the surface silicone layer was removed.
Toenail bed was embedded before surgery (A). Artificial dermis was filled on both sides of the affected toe (B). After the artificial dermis filling, the nail bed was obviously smooth (C). Postoperative appearance of the affected toe (D). Appearance of the affected toe 1 month after surgery (E). Appearance of the affected toe 3 months after surgery (F). Appearance of the affected toe 9 months after surgery (G). Appearance of the affected toe 1 year after surgery (H).
fsurg-09-1047171-g003.jpg
PMC9869056_01_fsurg-09-1047171-g003.jpg
F3
The whole operation process is shown in Figures 3A-D. The follow-up 1 month after surgery showed complete healing of the surgical wound and well growth of the nail with the DLAD (Figure 3E). The growth rate of the bilateral area of the nail was lower than that of the middle part of the nail, and the nail plate was abnormally thickened (Figure 3F). Nine months after the operation, we saw that the nail plate growth improved obviously, the curvature index reached 87.5%, and the VAS score reduced to 1 (Figure 3G). So far, the nail plate is fully grown and looks good; the patient has not felt pain and is back to work, feeling satisfied with this operation (Figure 3H).
Schematic diagram of the procedure.
fsurg-09-1047171-g004.jpg
PMC9869056_01_fsurg-09-1047171-g004.jpg
F4
The schematic diagram of this procedure is shown in Figure 4.