Partial Matrix Excision or Orthonyxia for Ingrowing Toenails

Abstract

BACKGROUND:We wanted to evaluate whether partial matrix excision and orthonyxia are equally effective in the treatment of ingrown toenails of the hallux. STUDY DESIGN: We conducted a prospective randomized clinical trial with 12-month observer-blinded followup, in the surgical outpatient department of a teaching hospital. We randomized 105 consecutive patients with a total of 109 ingrown toenails to either partial matrix excision (n ϭ 58) or an orthonyxia procedure (n ϭ 51). The main outcomes measurements were rate of recurrence after 12 months, postoperative morbidity, and time to complete recovery. RESULTS:The 12-month followup was completed in 55 of 58 patients undergoing partial matrix excision and 47of 51 patients having orthonyxia. There were four ingrown toenails, four recurrences in the partial matrix excision group, and eight in the orthonyxia group (NS, p ϭ 0.14). Postoperative morbidity parameters (redness, pus, postoperative bleeding); time to complete recovery, wearing shoes (p Ͻ 0.01), and performing activities of daily living and hobbies; postoperative symptoms; and patient satisfaction all favored orthonyxia. CONCLUSIONS: Partial matrix excision and orthonyxia are equally effective treatments for ingrown toenails. But the orthonyxia procedure showed better results, with less postoperative morbidity, shorter time to complete recovery, fewer postoperative symptoms, and greater patient satisfaction.

Novel treatment using thioglycolic acid for pincer nails

“…Kruijff et al . suggested that the best treatment for nail deformity should be both effective and painless.…”

Efficacy of Nail Brace Treatment For Ingrown Nails

“…Evre 1 t›rnak batmas›nda; hafif eritem, ödem ve batan t›rnak çevresinde a¤r›, evre 2 t›rnak batmas›nda: eritem ve ödemin kötüleflme-sine ek olarak enfeksiyon ve drenaj, evre 3 t›rnak batmas›nda ise evre 2'deki bulgulara ek olarak lateral t›rnak kenar› hipertrofisi ve granulasyon dokusu mevcuttur 1,2,3,4 . Evre 2-3 t›rnak batmas› flikayeti mevcut olan hastalarda genellikle uygulanan matrisektomili veya matrisektomisiz parsiyel ya da total t›r-nak çekimi tel uygulamas›na göre, daha pahal›, kanama, enfeksiyon, a¤r› ve deformite gibi komplikasyonlar› olabilen ve cerrahi sonras› ifl kayb›na yol açan yöntemlerdir 5,6,7 . Erken evre enfeksiyon geliflimi olmayan olgularda tel uygulamas› operasyona göre yaklafl›k üçte bir oran›nda ucuz görünmekte iken, komplike ve enfekte olgularda bu maliyet fark› 4-5 kata kadar ç›kabilmektedir.…”

“…Bizim bu çal›flmam›zda etkinli¤ini de¤erlendirmeyi amaçlad›¤›m›z t›rnak teli uygulamas› t›rnak batmas› tedavisinde kolay ve ucuz bir tedavi alternatifidir. Dünya literatürlerinde de t›rnak tellerinin t›rnak batmas›nda baflar›yla uyguland›¤›na dair yay›nlar bulunmaktad›r 2,5,6,8 . Çal›flmam›zda , 1) De¤iflik kal›nl›ktaki batan t›rnaklarda t›rnak teli uygulamas›n›n etkinli¤i, 2) Tedavi kesilmesinden sonra nüks s›kl›¤›n›n saptanmas›, 3) Nüks için mevcut risk faktörlerinin tan›mlanmas› amaçlan-maktad›r.…”

“…Bizim çal›flmam›zda da nüks oran› %16,9 olarak tespit edilmifl olup literatürlerle uyum göster-mektedir 5,6 . "Orthonyxia" ile yap›lan çal›flmalarda , bu uygulamada ön-ce t›rnak kenar›ndaki batan k›s›m çekilmekte ve ifllemden 1 hafta sonra tel uygulanmaktad›r.…”

An Evaluation of Partial Matrix Excision with Winograd Method for the Surgical Treatment of Ingrown Toenails

“…Hyperplasia occurs as a result of irritation of the nail groove and the reaction of the surrounding soft tissues. Finally, the nail substance enters the nail groove and causes infection (5)(6)(7)(8)(9)(10). Although there are many conservative and surgical treatments for ingrown toenails, the optimum treatment method has not been clearly defined because of the high recurrence rates, low degrees of patient satisfaction, and reported cosmetic issues.…”