Traumatic Nail Disorders

Abstract

Onychogryphosis, otherwise known as “ram’s horn nail,” is an extreme example of unbridled nail growth.⁹ It is a condition in which the nails become thickened and enlarged in response to trauma (e.g., wearing occlusive footwear), causing the nail to curve away from the source of pressure (Figure 42).⁹ This condition typically develops in middle-aged or elderly persons, many of whom have bunions or wear pointed-toe shoes. In children, onychogryphosis is often a sign of neglect or may be associated with congenital malalignment, trauma, or external pressure from a first pair of poorly fitting shoes.¹⁰ Onychogryphosis typically develops over the course of many years and may be associated with a dermatophyte infection.⁹ Such nail growth may make it difficult for an individual to walk normally or to wear shoes.⁹