[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-661509-105":59,"doc-detail-661509-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","nail-surgery-chapter-33-anatomic-terminology-and-common-procedures","Nail Surgery - Chapter 33 - Anatomic Terminology and Common Procedures","","Nail surgery outlines core approaches to treating pathological or undesirable nail tissue, focusing on excision with sharp instrumentation versus destruction by chemical, freezing, electrogalvanism, burring, or laser methods. Emphasis is placed on accurate nail anatomy terminology, especially the nail matrix location, due to its impact on procedural success. Sections address direct nail trauma leading to subungual hematoma and techniques for decompression or avulsion, followed by discussion of onychocryptosis etiology and classification considerations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/nail-surgery-chapter-33-anatomic-terminology-and-common-procedures/661509/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/nail-surgery-chapter-33-anatomic-terminology-and-common-procedures/661509.png","ImageObject",300,407,{"name":92,"@type":93},"AfterMidnight","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-10-28",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What are the two basic categories of nail surgery described?","Question",{"text":112,"@type":113},"Nail surgery is divided into excision of pathological or undesirable tissue using sharp instrumentation, or destruction of the pathological tissue by physical or chemical means such as chemicals, freezing, electrogalvanism, burring, or lasering.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How should a subungual hematoma after direct nail trauma be managed?",{"text":117,"@type":113},"The subungual hematoma should be evacuated to relieve pressure on the nail bed and reduce pain and deforming forces. Techniques mentioned include burning through the nail with a red-hot paper clip or using cautery, and other decompression methods such as a rotating large-bore needle.",{"name":119,"@type":110,"acceptedAnswer":120},"What causes onychocryptosis according to the text?",{"text":121,"@type":113},"The text lists multiple theories, including improper debridement by patients, ill-fitting shoes, subungual exostosis, excessive soft tissue, hypermobility of the first metatarsal segment, hallux valgus, trauma to the nail matrix or nail bed, and nail thickening from onychomycosis that can create a cryptotic border.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},661509,1793168629,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":129,"read_time":144},962090896061,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Nail surgery can be divided into two basic categories: excision of the pathologic or undesirable tissue by use of sharp instrumentation, or destruction of the pathologic tissue by physical means such as chemicals, freezing, electrogalvanism, burring, or lasering. Currently, the procedures most popular and most regularly performed are chemical. However, laser surgery is gaining popularity because the public currently perceives laser surgery as being in vogue.  \nANATOMY  \nIt is important to understand the standard terminology used when examining the nail and performing nail surgery. Most terms are fairly common and easy to understand 1 (Fig. 33-1) . When reviewing the literature, discrepancies are seen in the exact location of the nail matrix, which is a pivotal point in the success or failure of certain procedures. There seems however to bea general agreement as to the posterior location of the matrix.1-7  \nAs depicted 1 (see Fig. 33-1), some authors describe the nail matrix as having a \"wrap-around characteristic\"7 and therefore being located dorsal and plantar to the nail root. Others have depicted the nail matrix as being plantar or plantar and proximal to the nail root only. Anatomy text descriptions ofthe exact location of the nail matrix seem vague and nonspecific. It is suggested at this time that the low recurrence rate of chemical matrixectomies may be attributed to the fact that the nail matrix dorsal to the nail is destroyed by the nature of the procedure, which would lend support to the idea of a wrap-around characteristic of the nail matrix. Further studies specifically designed to  \nidentify the exact location of the nail matrix and its nail borders must be performed.  \nDIRECT TRAUMA TO THE NAIL  \nDirect trauma to the nail from stubbing the toe or a falling object may lead to formation of a subungual hematoma. The subungual hematoma should be evacuated to relieve any pressure that may be being applied to the nail bed and causing the patient pain, as well as relieving any deforming force the hematoma may be applying to the nail itself. Wee and Shieber described using a red-hot paper clip to burn through the nail and decompress the hematoma, thus avoiding use of anesthetics and unnecessary discomfort to the patient.8 Palamarchuk and Kerzner9 describe using a hand-held cautery device for evacuation of subungual hematoma. If the podiatric physician has access to a laser, a small, precise portal of evacuation for the subungual hematoma can be created but this will require anesthesia because of the surrounding heat created.  \nI prefer using a large-bore needle in a rotating fashion to evacuate the hematoma. Minimal pressure is required to penetrate the nail, and anesthesia is usually not necessary. In cases of old subungual hematoma where coagulation has already occurred, a sterile burr may be used to deroof a portion of the nail over the hematoma so that a sterile currette or other instrument can be used to evacuate the coagulated tissue.  \nDirect trauma may also result in partial lysis or separation of the nail from the nail bed. Usually any type of pressure, such as the upper of a shoe will cause excruciating pain. It is recommended that a total nail avulsion be performed to relieve discomfort, prevent further traumatic onycholysis, and prevent  \n482 HALLUX VALGUSAND FOREFOOT SURGERY  \nFig. 33-1. Common terminology of nail anatomy. (Illustration by Marlene Burns.) (From Burns et al., 1) .  \ninfection, because a lysed nail is no longer an effective barrier against microbes. Several techniques can be used to perform a total nail avulsion. After suitable prepping and anesthesia, a periosteal elevator or a flat spatula is used to separate the nail from the nail bed, as well as the nail plate from its dorsal attachments to the posterior nail fold. The nail may be avulsed with a hemostat. Forcefully removing the nail from the toe may fragment the nail and unnecessarily traumatize the nail bed and nail matrix. Therefore, ad","cbCaim1lOTkq0Gea","https://ap.wps.com/l/cbCaim1lOTkq0Gea","pdf",1367625,17,"English","# Nail Surgery\n## Basic approaches and popularity of chemical procedures\n## Anatomy and nail terminology\n## Direct trauma and subungual hematoma\n## Total nail avulsion techniques\n## Onychocryptosis etiology and classifications","[{\"question\":\"What are the two basic categories of nail surgery described?\",\"answer\":\"Nail surgery is divided into excision of pathological or undesirable tissue using sharp instrumentation, or destruction of the pathological tissue by physical or chemical means such as chemicals, freezing, electrogalvanism, burring, or lasering.\"},{\"question\":\"How should a subungual hematoma after direct nail trauma be managed?\",\"answer\":\"The subungual hematoma should be evacuated to relieve pressure on the nail bed and reduce pain and deforming forces. Techniques mentioned include burning through the nail with a red-hot paper clip or using cautery, and other decompression methods such as a rotating large-bore needle.\"},{\"question\":\"What causes onychocryptosis according to the text?\",\"answer\":\"The text lists multiple theories, including improper debridement by patients, ill-fitting shoes, subungual exostosis, excessive soft tissue, hypermobility of the first metatarsal segment, hallux valgus, trauma to the nail matrix or nail bed, and nail thickening from onychomycosis that can create a cryptotic border.\"}]","Nail Surgery - Chapter 33 - Anatomic Terminology and Common Procedures | PDF",43]