Surgical treatment of ingrown toenails

Surgical Treatment of Ingrown Toenails

The surgical treatment of ingrown toenails is a medical intervention aimed at resolving cases of ingrown toenails that cannot be effectively managed through conservative measures. Ingrown toenails, or onychocryptosis, occur when the edge of a toenail grows into the surrounding skin, causing pain, inflammation, and sometimes infection. When conservative treatments fail or in recurrent severe cases, surgical options are considered to provide a permanent solution.

Introduction

Ingrown toenails are a common condition affecting individuals of all ages but are particularly prevalent among teenagers and young adults. Factors contributing to their development include improper nail trimming, tight-fitting footwear, and genetic predisposition. Surgical intervention becomes necessary when there is significant pain, recurrent infection, or when the condition severely impacts the patient's quality of life.

An ingrown toenail showing signs of infection.

Causes of Ingrown Toenails

• Improper nail trimming: Cutting nails too short or rounding the corners can encourage the skin to fold over the nail.
• Tight footwear: Shoes that are too tight can compress the toes, pushing the nail into the skin.
• Trauma: Injury to the toenail can distort its growth pattern, leading it to grow into the skin.
• Genetic predisposition: Some individuals are born with toenails that are more curved and tend to grow into the skin.

Indications for Surgery

Surgery is considered for ingrown toenails when there is:

• Recurrent infection, causing significant pain and mobility issues.
• Failed conservative treatment, including proper nail care, warm soaks, and antibiotic therapy.
• Severe cases where the nail's shape or chronic conditions, such as diabetes, increase the risk of complications.

Common Surgical Procedures

Partial Nail Avulsion with or without Phenolization

The most common surgical treatment involves removing a portion of the nail along with the underlying tissue to prevent regrowth of the ingrown section. Phenolization, the application of phenol to the nail matrix, may be used to permanently prevent regrowth of the affected nail edge.

Total Nail Avulsion

In severe cases, the entire toenail may be removed. This option is less commonly pursued due to the potential for aesthetic concerns and the risk of recurrence if the nail matrix is not adequately addressed.

Matrixectomy

A matrixectomy involves the surgical removal of the nail matrix to permanently prevent nail regrowth in the treated area. This procedure is often considered for patients with chronic and recurrent ingrown toenails.

Post-Operative Care

Effective post-operative care is crucial for healing and includes:

• Keeping the foot elevated to reduce swelling.
• Regular dressing changes to prevent infection.
• Pain management, typically with over-the-counter pain relievers.
• Following the surgeon's instructions on wound care and activity restrictions.

Prevention Strategies

Preventing ingrown toenails involves:

• Proper nail trimming: Cut nails straight across and avoid trimming too short.
• Wearing well-fitted shoes with adequate room for the toes.
• Maintaining good foot hygiene.

See Also

• Podiatry
• Foot health
• Nail diseases

External Links

• American Family Physician - Management of Ingrown Toenails
• American Podiatric Medical Association - Ingrown Toenail

References

• "Surgical approaches to ingrown toenails." Journal of Podiatric Medical Surgery.
• "Postoperative care following ingrown toenail surgery." Foot & Ankle International.

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