The surgical management of ingrowing toenail

Abstract

A retrospective review has been carried out on 200 randomly selected patients with ingrowing toenail in order to assess the surgical management and its results. There was a predominance of males between the ages of 11 and 30 with an ingrowing toenail. Despite the high recurrence rate following simple avulsion of the toenail, its place in the initial management of the condition is justified. As regards more definitive surgery, total proximal nail bed ablation was found to give the best results. Sepsis at the time of operation neither increased the recurrence rate nor caused severe postoperative sepsis. A surgical management policy for the treatment of ingrowing toenail is outlined and discussed.

Ingrown toe nail as seen in Bayelsa state Nigeria

“…1 In another study, Murray et al had noted that ingrown toe nails occurred more often in young male adults between ages of 12 to 30 years. 3 Our findings agree with these reports for the majority 20 (71.43%) of our patients were teenagers and young adults between the ages of 11 to 40 years who are normally involved with sport and other physical activities. Again, our study showed that subtle trauma, use of tight shoes and defective cutting of the nails may be etiologic agents.…”

“…Previous reports by Murray et al have also stated that in-grown toe nails occurred more in teenagers and young adults involved in sports and physical training. 3 In their series, Ariel et al had noted that it occurred most often between the ages of 15 to 40 years. 1 In another study, Murray et al had noted that ingrown toe nails occurred more often in young male adults between ages of 12 to 30 years.…”

“…1,4,5 Murray et al had noted that 73% of ingrown toe nails occur in young adults between the ages of 12-30 years, those who wear tight shoes and particularly among physical trainers, sports and military men. 3 Scher RK et al also noted that diabetes, obesity and patients with cardiac disorders are more predisposed to developing ingrown toe nails. They also noted that those who have thyroid or renal disorders that have increased lower extremity edema are more likely to develop the disease.…”

“…12 This reports varies widely with the low reoccurrence rates between 5% to 9% following nail edge excision followed by chemical matricectomy using phenol by GrieG et al 12 In another series, Cameron et al in 1988 and Murray et al in 1982 using the same method of nail wedge excision with phenolization, had a recurrent rate as low as between 3% to 25%. 3,14 In our study, wedge resection of the nail with surgical matricectomy was done. Our recurrent rate after a year follow-up was 17.85%.…”

Medical Treatment of Ingrown Toenails by Chemical Matricectomy Using Phenol

“…Unacceptably high recurrence rates, poor cosmetic results, and significant postoperative pain have been associated with conventional surgical treatments [7,8]. Published studies indicate that total nail avulsion is associated with a recurrence rate of 83% and simple nail edge removal has a recurrence rate of 39%, while soft tissue resection may cure as many as 60% of cases [7,8,9,10,11].…”