Common invasive procedure.
Indicated for involuted nail with hypertrophied skin.
• nail split longitudinal with nail or bone cutters – scalpel extends this 1cm proximal to eponychium deep to bone
• second semi elliptical incision to join the ends of the first
• both incisions deepened to remove nail and hypertrophied skin
• periosteum of bone is rasped to expose bone and eradicate nail matrix
• hypertrophied skin still present is remodelled and sutured
• steristrips also used to hold in place