A new perspective on the nail plate for treatment of ingrown toenail

Abstract

BackgroundOur routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of excision based on our experience without an objective standard and routinely performed avulsion of the nail plate.ObjectiveTo take the nail plate as an objective mark during surgical treatment of ingrown toenail to ensure accurate excision.Patients and MethodsFifteen patients with ingrown toenails were treated with this technique. We used the lateral borders of the nail plate as a landmark to determine the volume of soft tissue surrounding the nail plate and distal phalanx to be removed. No avulsion of nail plate was performed.ResultsNo recurrence was observed during the follow-up period, which ranged from 24 to 35 months (29.9 months on average). The visual analog scale for pain showed significant pain relief in the patients. The Vancouver Scar Scale showed acceptable cosmetic outcomes. The width of excised skin ranged from 3.5 to 6.2 mm (5.0 mm on average).ConclusionThe use of the lateral borders of the nail plate as a landmark for surgical intervention of ingrown toenail offered excellent outcomes and reduced loss of healthy tissues.

A case of ingrown nail using buckle VHO‐Osthold® Perfect as a method of conservative treatment

“…Complications following surgical interventions may include significant postoperative pain, prolonged wound healing, risk of bone infection or other infections, and a longer recovery period compared to conservative methods. 2,13 In order to avoid surgical treatment requiring convalescence, alternative methods should be considered if the nail condition is not a contraindication. One of the few methods to correct ingrown nails is the three-part VHO-Osthold® Perfect orthonic buckle, which is the domain of podiatrists and professionals in foot care.…”

“…Although surgical treatment can achieve a rapid effect by completely removing the completely ingrown nail or the surrounding tissue, it should be borne in mind that these are invasive actions and can lead to deformations of the nail plate at a later stage of its growth. Complications following surgical interventions may include significant postoperative pain, prolonged wound healing, risk of bone infection or other infections, and a longer recovery period compared to conservative methods 2,13 . In order to avoid surgical treatment requiring convalescence, alternative methods should be considered if the nail condition is not a contraindication.…”

“…This problem is observed in 20% of the population, in all age groups, but is most common in teenagers and young adults aged 11-30 years. [1][2][3][4] The process of nail ingrowing stimulates the natural defense mechanisms of the body, in the form of inflammation. The basic symptoms include swelling, redness, and pain in the nail fold at the point of the ingrowing or within the entire phalange.…”

“…This disorder concerns mainly a big toe, rarely the fifth toe or fingernails. This problem is observed in 20% of the population, in all age groups, but is most common in teenagers and young adults aged 11‐30 years 1‐4 …”

Review of onychocryptosis: epidemiology, pathogenesis, risk factors, diagnosis and treatment

“…Treatment can be approached either conservatively (non-surgical) or surgically. Conservative treatment is often effective for stage I, whereas stages II and III often require surgical intervention [22,23]. A 2012 Cochrane systematic review concluded that surgical interventions were more effective in preventing recurrence, especially when coupled with phenol application, but more evidence-based research was required [2].…”