Indicated for involuted edge of nail plate with minimal or no hypertrophy of skin
Allow maximum visual exposure of nail matrix.
Infections needed to eradicated prior to surgery

• nail split with bone forceps
• scalpel place in grove of cut and incision made deep to bone and 10mm past eponychium
• another incision made 90 degrees at proximal end of prior incision to create an L shaped skin flap
• flap retracted with care (risk of ischaemia)
• two incisions (V shaped) to remove a “piece of pie” of nail, nail bed and nail matrix.
• periosteum also removed to ensure all nail matrix removed (may rasp bone)
• L shaped flap is sutured back in place

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