Abstract
Nail surgery is mainly performed by dermatologists, hand and plastic surgeons, as well as general surgeons. Provided the surgeon has an in-depth knowledge of the anatomy and biology, as well as the pathology, of the nail organ and its surrounding tissues, good results with excellent function and good cosmetic outcome can usually be achieved, depending on the original diagnosis. This article describes pre- and postoperative care, the different methods of anesthesia, as well as some of the most commonly performed nail operations and their complications. Nail avulsion is commonly performed in a traumatic manner. Ingrown toenails require an approach adapted to their type, pathogenesis and degree of severity. Nail tumors, although rare, can be treated with good functional results if they are not far advanced and malignant. Ungual melanomas do not require amputation of the digit if they are not too advanced and several methods are available to cover the defect after complete ablation of the dorsal half of the distal phalanx (e.g., full-thickness or reversed dermal grafts and cross-finger flaps). Matrix grafts are useful to replace scars with nail-forming epithelium. Complications are rare, but should be treated immediately in order to avoid permanent nail dystrophy.