Nail surgery: a review.

The nail, the largest of the skin adnexa, is unique to primates and appears to have evolved from the claw of lower animals.' It has many functions,' the most important of which is prehension. Without nails our ability to grasp and manipulate objects would be limited. Nails also protect the delicate distal phalanx and the soft tissues of the distal digit. For man, the nail is also of cosmetic importance. Lastly, as objects with which to scratch, nails can give dramatic and immediate relief to localized areas of pruritus. Since disorders or dysfunctions of the nail apparatus often come to the dermatologist's attention for treatment, his ability to perform nail surgery necessarily broadens his diagnostic and therapeutic capabilities in managing these complaints. A discussion of some principles of nail surgery and specific surgical techniques used in the treatment of such disorders follows.