TNA- Total Nail Avulsion

Nail avulsion is the excision of the body of the nail plate from its primary attachments, the nail bed ventrally and the PNF dorsally. Avulsion of the nail plate may be initially performed to allow full exposure of the nail matrix before chemical matricectomy. Other indications for performing nail avulsion are to treat recalcitrant onychocryptosis (ingrown toenails); to excise tumors of the nail unit; to allow full examination and exploration of the nail bed, the nail matrix and the nail grooves for the presence of pathology; or to use as a preliminary step before performing biopsy on the nail bed and the nail matrix.

Avulsion of the nail plate is frequently used as a therapeutic adjunct in long-standing fungal infections of the nail, such as chronic onychomycosis, and in acute bacterial infections. In traumatic nail injuries, avulsion may be used to evaluate the stability of the nail bed or to release a subungual hematoma after failed puncture aspiration.

*Article: Nail Surgery Treatment & Management by Neh Onumah

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