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THROUGH THE LENS
Ahead of print publication  

An outcome of traumatic fingertip amputation- “The Hooked Nail”


 Department of Dermatology, Kasturba Medical College, Manipal, Karnataka, India

Date of Web Publication20-Jun-2021

Correspondence Address:
Raghavendra Rao,
No 21, 2nd Floor, Department of Dermatology, Kasturba Hospital, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_602_20



How to cite this URL:
Sandhiya R, Rao R. An outcome of traumatic fingertip amputation- “The Hooked Nail”. Indian Dermatol Online J [Epub ahead of print] [cited 2021 Nov 27]. Available from: https://www.idoj.in/preprintarticle.asp?id=318472



A 28- yr-old male, presented with a painful deformed nail over the left index finger since 6 months. He had sustained a road traffic accident one year ago leading to a lacerated wound which was sutured at a local hospital. Examination revealed a dorsoventrally curved nail plate covering the tip and extending up to the pulp of the finger; distal phalanx was shortened. This resembled the head of a hook nail [Figure 1]a [Figure 1]b [Figure 1]c [Figure 1]d and [Figure 2]a, [Figure 2]b. Hooked nail usually develops after a traumatic amputation of the distal phalanx; this leads to loss of bony support to the nail bed.[1] The nail matrix is pulled over the end of the bone causing hooking. The nail plate that arises from this matrix follows the course of the nail bed. Hooked nail can be prevented by V-Y advancement flaps/triangular osteocutaneous flaps.[2] Asymptomatic hooking can be managed by a prosthesis (pillet hand or sub-minidigital) whereas surgery is indicated for symptomatic cases.[3],[4],[5]
Figure 1: Hooking of the nail dorsoventrally over the left index finger, with normal cuticle, and proximal nail fold. The distal phalanx appears shortened, with visible scars (c) over the dorsa of the distal phalanx suggestive of previous trauma. The deformed nail is depicted in the lateral (a and b), dorsal (c), and ventral (d) views

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Figure 2: The curved nail plate (a) is analogous to the head of a hook nail (b)

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Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kumar VP, Satku K. Treatment and prevention of “hook nail” deformity with anatomic correction. J Hand Surg Am 1993;18:617-20.  Back to cited text no. 1
    
2.
Garcia-Lopez A, Laredo C, Rojas A. Oblique triangular neurovascular osteocutaneous flap for hook nail deformity correction.J Hand Surg Am 2014;39:1415-8.  Back to cited text no. 2
    
3.
Koshima J, Soeda S, Takase T, Yamasaki M. Free vascularized nail grafts. J Hand Surg Am 1988;13:29-32.  Back to cited text no. 3
    
4.
Pillet J, Didearjean-Pillet A. Ungual prosthesis. J Dermatol Treatment 2001;12:41-6.  Back to cited text no. 4
    
5.
Beasley R W, de Bez G. Prosthetic substitution for finger nails. Hand Clin 1990;6:105-12.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

 
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