Gradual correction of nail deformity with adjustable tension: a new technique using steel wire and elastic components

Introduction Nail deformity is a common condition in podiatry, affecting 15–20 % of the population at different stages of their life. The disorder can cause chronic pain with a greater risk of infectious complications and significant limitations in activities of daily living. Minimally invasive and affordable solutions are needed for the problem. The key difference between the technique proposed and similar approaches lies in a rigid wire to be replaced with elastic components to allow  adjustable gradual nail tensioning and stable fixation.

The objective was to determine the effectiveness of a minimally invasive technique using a steel wire combined with elements of elastic orthodontic chains made of medical polyurethane (elastofors) or nickel-titanium metal alloy in the form of nitinol springs to provide adjustable gradula tension for nail deformity correction.

Material and methods The method suggests creating customized corrective systems based on a steel wire and a selected active element. The systems are secured to the nail with hooks, ensuring constant, controlled tension. The study included patients with various types of nail deformities, excluding those with acute inflammatory processes. Standard orthonyxia instruments and elastic elements (Elastofors and nickel-titanium springs) were used. Results were assessed by measuring the nail width and tension force every two weeks for two months.

Results and discussion The technique demonstrated high efficacy in correcting different types of nail deformities, with the nail width increasing from 2 mm to 4.1 mm over eight weeks. The technique is minimally invasive and causes no discomfort to patients. Elastic elements provide a gentle and comfortable pressure on the nail without affecting the patient's ability to function or perform daily activities. The technique is universal and applicable to different types of deformities. Prospects for further research might include introduction of adhesive platforms for uniform pressure distribution; the study of alternative alloys (titanium-molybdenum, cobalt-chromium) and optimization of wire-free Elastofors fixation.

Conclusion The technique was shown to be effective in the nail deformity correction, combining minimal invasiveness, adaptability and aesthetics. The results offer potential for implementation in clinical practice with an emphasis on personalized treatment.

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