{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:17:10Z","timestamp":1783430230012,"version":"3.54.6"},"reference-count":16,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,11,1]]},"abstract":"<jats:p>Development of a ski-slope deformity following loss of the great toe nail plate is a problematic condition with few conservative or surgical options available. The condition becomes more difficult to treat when the distal, medial, and lateral labial nail folds are hypertrophied, creating the appearance of a sunken nail. We present a case of ski-slope, sunken-nail deformity following multiple attempts at chemical nail matrixectomy. The patient\u2019s persistent pain and deformity were managed through 1) nail plate avulsion and complete surgical excision of the germinal nail matrix, 2) remodeling of the distal phalanx, and 3) elevation of an adipofascial flap from the plantar tuft of the great toe, which was brought from plantar to dorsal and interposed between the dorsal aspect of the distal phalanx and the overlying nail bed in buried fashion. The combination of these procedures elevated the nail bed, which restored normal architecture to the great toe and relieved the pain associated with the chronic deformity. This case demonstrates a potential complication of a commonly performed procedure and a salvage technique useful for dealing with the resultant ski-slope, sunken-nail deformity (J Am Podiatr Med Assoc 94(6): 578\u2013582, 2004)<\/jats:p>","DOI":"10.7547\/0940578","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T10:31:33Z","timestamp":1396348293000},"page":"578-582","source":"Crossref","is-referenced-by-count":0,"title":["Reconstruction of the Great Toe Ski-Slope, Sunken-Nail Deformity with a Buried Adipofascial Flap"],"prefix":"10.3390","volume":"94","author":[{"given":"Thomas S.","family":"Roukis","sequence":"first","affiliation":[{"name":"Weil Foot and Ankle Institute, Des Plaines, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Landsman","sequence":"first","affiliation":[{"name":"Weil Foot and Ankle Institute, Des Plaines, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"2020060319253316000_R1","doi-asserted-by":"crossref","unstructured":"Bouche RT: Distal skin plasty of the hallux for clubbing deformity after total nail loss. .JAPMA85::11. ,1995. .","DOI":"10.7547\/87507315-85-1-11"},{"key":"2020060319253316000_R2","unstructured":"Howard AW: Ingrown toenail: its surgical treatment. .N Y Med Surg J57::579. ,1893. ."},{"key":"2020060319253316000_R3","doi-asserted-by":"crossref","unstructured":"Lapidus PW: Complete and permanent removal of toe-nail in onychogryphosis and subungual osteoma. .Am J Surg19::92. ,1933. .","DOI":"10.1016\/S0002-9610(33)90469-9"},{"key":"2020060319253316000_R4","unstructured":"DuVries HL: Hypertrophy of unguilabia. .Chiropody Rec16::11. ,1933. ."},{"key":"2020060319253316000_R5","unstructured":"Quenu M: Applications au traitement de l\u2019ongle incarne. .Bull Soc Chirurg Paris13::252. ,1887. ."},{"key":"2020060319253316000_R6","doi-asserted-by":"crossref","unstructured":"Zadik FR: Obliteration of the nail bed of the great toe without shortening of the terminal phalanx. .J Bone Joint Surg Br32::66. ,1950. .","DOI":"10.1302\/0301-620X.32B1.66"},{"key":"2020060319253316000_R7","doi-asserted-by":"crossref","unstructured":"Lai CS, Lin SD, Yang CC, et al: The adipofascial turnover flap for complicated dorsal skin defects of the hand and finger. .Br J Plast Surg44::165. ,1991. .","DOI":"10.1016\/0007-1226(91)90119-5"},{"key":"2020060319253316000_R8","doi-asserted-by":"crossref","unstructured":"Voche P, Merle M: The homodigital subcutaneous flap for cover of dorsal finger defects. .Br J Plast Surg47::435. ,1994. .","DOI":"10.1016\/0007-1226(94)90074-4"},{"key":"2020060319253316000_R9","doi-asserted-by":"crossref","unstructured":"El-Khatib H: Adipofascial axial pattern cross-finger flap. .Plast Reconstr Surg97::850. ,1996. .","DOI":"10.1097\/00006534-199604000-00028"},{"key":"2020060319253316000_R10","doi-asserted-by":"crossref","unstructured":"Cavadas PC, Puertes-Corella L: The subcutaneous turn-over flap in the treatment of difficult wounds in the digits. .J Hand Surg Br23::472. ,1998. .","DOI":"10.1016\/S0266-7681(98)80124-1"},{"key":"2020060319253316000_R11","doi-asserted-by":"crossref","unstructured":"Jeffery SLA, Pickford MA: Use of the homodigital adipofascial turnover flap for dorsal cover of distal interphalangeal joint defects. .J Hand Surg Br24::241. ,1999. .","DOI":"10.1054\/JHSB.1998.0057"},{"key":"2020060319253316000_R12","doi-asserted-by":"crossref","unstructured":"Espensen EH, Nixon BP, Armstrong DG: Chemical matrixectomy for ingrown toenails: is there an evidence basis to guide therapy?. 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