Hook nail explained

Synonyms:	Hook nail deformity

Hook nail is a bowing of the nail bed due to a lack of support from the short bony phalanx (fingertip).^[1]

Signs and symptoms

The nail plate has volar concavity and a longitudinal hypercurvature. The patient may report discomfort, aesthetic impairment, and functional disability.^[2]

Causes

Hook nail is caused by trauma to the hyponychium.^[2] Hook nail is often seen after a fingertip amputation.^[3]

Prevention

Some publications propose shortening the nail bed to the end of the bony support if it continues past the limit of the severed distal phalanx in order to prevent deformity.^[4] Treatments intended to preserve length, such as replantation or flap reconstruction, should be used if the damage to the bone and soft tissue beneath the nail bed is too great.^{[5] [6]}

Treatment

Surgical options for hook-nail deformity include nail excision or finger shortening; alternatively, soft tissue reconstruction, bone grafting, nail recession, or partial toe transfer may be used to try to add some support to the nail bed.^[3]

See also

• Half and half nails
• List of cutaneous conditions

Further reading

• Dumontier . C. . Gilbert . A. . Tubiana . R. . Hook-Nail Deformity: Surgical treatment with a homodigital advancement flap . Journal of Hand Surgery . 20 . 6 . 1995 . 0266-7681 . 10.1016/S0266-7681(95)80057-3 . 830–835 . 8770751 . none.
• Strick . M. J. . Bremner-Smith . A. T. . Tonkin . M. A. . Antenna Procedure for the Correction of Hook Nail Deformity . Journal of Hand Surgery . 29 . 1 . 2004 . 0266-7681 . 10.1016/j.jhsb.2003.08.007 . 3–7 . 14734059 . none.

Notes and References

1. Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. .
2. Silva Junior . Francisco Milton da . Oliveira . Marcelo Tavares . Angelini . Luiz Carlos . Chung . Wu Tu . Treatment of hook nails using the Bakhach's technique: a retrospective study . Surgical & Cosmetic Dermatology . 13 . 2021 . 1984-8773 . 10.5935/scd1984-8773.2021130039 . free .
3. Poumellec . Marie-Anne . Camuzard . Olivier . Dumontier . Christian . Hook nail deformity . Hand Surgery and Rehabilitation . Elsevier BV . 2024 . 2468-1229 . 10.1016/j.hansur.2024.101649 . 101649. 38280632 .
4. Kumar . V.P. . Satku . K. . Treatment and prevention of "hook nail" deformity with anatomic correlation . The Journal of Hand Surgery . Elsevier BV . 18 . 4 . 1993 . 0363-5023 . 10.1016/0363-5023(93)90303-k . 617–620. 8349967 .
5. Pandya . Ankur N. . Giele . Henk Peter . Prevention of the Parrot Beak Deformity in Fingertip Injuries . Hand Surgery . 06 . 2 . 2001 . 0218-8104 . 10.1142/S0218810401000631 . 163–166.
6. Netscher . David T. . Meade . Ricardo A. . Reconstruction of Fingertip Amputations with Full-Thickness Perionychial Grafts from the Retained Part and Local Flaps . Plastic and Reconstructive Surgery . Ovid Technologies (Wolters Kluwer Health) . 104 . 6 . 1999 . 0032-1052 . 10.1097/00006534-199911000-00014 . 1705–1712.