Abstract
There are three main types of nail malalignment. These are: congenital nail malalignment of the big toenail, traumatic nail malalignment, and iatrogenic malalignment of the nail plate. Treatment is only of benefit in the first two conditions, and specific surgical approach to each condition is outlined. The probable mechanism of iatrogenic malalignment is discussed. Nail rotation for congenital malalignment produces its best results in early childhood. Surgery is of benefit in congenital malalignment and traumatic malalignment and is worthwhile in selected cases. Iatrogenic malalignment that is the consequence of wide lateral nail biopsies or similar excisions does not respond to treatment.
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