Suffering from a severely painful toenail that is constantly irritated with shoes and impossible to cut?  Surgical removal is most likely the best option.  Toenail deformities can be the result of trauma to the nail plate which can occur from dropping something on your toe, or simply through years of irritation of the nail plate on a shoe.  Nail fungus can also be the cause of a deformed toenail, so it is imperative to first have the nail tested for fungus before making any decisions to permanently remove the toenail.