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Modified scissors for partial nail avulsion: An alternative to traditional nail clippers and surgical scissors
*Corresponding author: Samkit Satish Shah, Department of Dermatology, Venereology and Leprosy, Vedantaa Institute of Medical Sciences and Research Centre, Palghar, Maharashtra, India. samkitshah1234@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Shah SS, Shah SH, Das JD, Pawar KN. Modified scissors for partial nail avulsion: An alternative to traditional nail clippers and surgical scissors. J Onychol Nail Surg. doi: 10.25259/JONS_1_2026
PROBLEM
Partial nail avulsion is commonly performed for conditions such as ingrown toenails (onychocryptosis).[1] However, traditional instruments often lack precision, particularly near the proximal nail fold. We propose a modified scissor design that improves access to the proximal nail fold and enables controlled partial or proximal nail plate avulsion. In addition, the instrument can be used for tangential excision of selected pigmented lesions involving the nail matrix. This innovation enhances precision, reduces trauma and minimises post-operative complications. Unlike the commonly used English anvil splitter, which is primarily designed for cutting thick nail plates, the modified scissors allow precise sub-plate access without causing undue separation of the nail plate from the nail bed. The tool offers better control, particularly for thick or brittle nails, thereby improving overall patient outcomes. Precise avulsion techniques are essential to avoid complications; however, traditional nail clippers and surgical scissors often lack the precision, especially in the region of the proximal nail fold. Residual nail fragments or spicules may result in persistent inflammation, pain, delayed healing and recurrence of symptoms.
The English anvil splitter is the principal instrument used for sectioning thick nail plates.[2] While effective for cutting, it has a very thick base. During attempts to introduce it beneath the nail plate, this bulky base often causes premature separation of the nail plate from the underlying nail bed, which ideally should be preserved during controlled avulsion. This limits precision, in this location. In addition, certain procedures, such as partial or proximal nail plate avulsion performed to facilitate tangential excision of selected pigmented lesions of nail matrix, require fine control, underscoring the need for a modified tool that allows safe and precise proximal nail manipulation.
SOLUTION
We propose a novel modification of standard surgical scissors to address the challenges encountered during partial and proximal nail plate avulsion. In this design, the upper outer end of the scissors is shortened by approximately 5 mm, and the lateral side of the lower outer end is reduced by approximately 2 cm [Figure 1a]. These modifications significantly improve access beneath the proximal nail fold and allow controlled, precise cutting of the nail plate. The modified scissors enhance surgical precision, reduce procedural trauma and minimise patient discomfort. They offer improved manoeuvrability and control, particularly in cases involving thickened or brittle nail plates. The flat upper surface and blunted, rounded tip facilitate safe entry beneath the proximal nail fold while minimising the risk of injury to the nail bed, matrix or cul-de-sac.
In contrast to the English anvil splitter [Figure 1b] whose thick basal design inadvertently lifts the nail plate from the nail bed during insertion [Figure 2a], the modified scissors allow gradual sub-plate advancement with minimal disruption of the nail bed [Figure 2b]. This controlled approach is especially advantageous in proximal nail procedures and matrix-adjacent interventions. Compared with conventional fine-tipped scissors, the thicker blades of the modified instrument provide greater durability and cutting strength. The projection on the lower blade acts as a protective guard [Video 1], limiting excessive penetration and thereby reducing the risk of inadvertent damage to the underlying nail bed or matrix. These features collectively ensure complete excision of the nail plate and reduce the likelihood of spicule retention and recurrence.
Video 1:
Video 1:Demonstration of nail surgery using modified scissors for partial nail avulsion. The video highlights the precise cutting of the nail plate, particularly in the proximal nail fold, showcasing the enhanced accessibility and efficiency provided by the modified design.Authors’ contributions:
Dr. Samkit Shah: Conceptualization, study design, critical revision, supervision, and final approval of the manuscript. Dr. Satish Shah, Dr. Joy Das: Data collection and analysis were performed. Dr. Kinnari Pawar: Literature review and manuscript drafting.
Ethical approval:
Institutional Review Board approval is not required.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given consent for clinical information to be reported in the journal. The patient understands that the patient’s names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript, and no images were manipulated using AI.
Financial support and sponsorship: Nil.
References
- Nail avulsion: Indications and methods (surgical nail avulsion) Indian J Dermatol Venereol Leprol. 2012;78:299-308.
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