Efficacy of Nail Braces for Acute and Chronic Ingrown Toenails: A Prospective Study

Abstract

BACKGROUND Nail braces are an alternative treatment for ingrown toenails. OBJECTIVE This study aimed to prospectively examine the efficacy of nail braces for treatment of acute inflamed (AI)-type and chronic dystrophic–type ingrown toenails. MATERIALS AND METHODS The authors conducted a prospective study of patients with ingrown toenails treated at Wan Fang Hospital between January 1, 2017, and July 31, 2018. Evaluation using physician global assessment scores and patient satisfaction questionnaires was performed at 1, 3, and 6 months after the start of treatment and during the final visit. Patient demographics, treatment courses, and outcomes were compared between the 2 types of ingrown toenails. RESULTS Chronic dystrophic–type and AI-type ingrown toenails were observed in 25 (61 sides) and 28 patients (35 sides), respectively. Of the affected sides, 80.9%, 94.9%, and 100% achieved an excellent or fair result at 1, 3, and 6 months, respectively. Treatment duration and follow-up period were 179.2 ± 96.8 days and 281.6 ± 120.9, respectively. The recurrence rate was 7.4%. The treatment course and response were different between the 2 types of ingrown toenails. CONCLUSION Ingrown toenails could be effectively treated with nail braces with excellent outcomes, favorable patient satisfaction, and low recurrence rates.

Risk factors for poorly controlled and recurrence-prone ingrown toenails treated with nail braces: A retrospective observational study of 238 cases

“…We used the hook-type brace, COMBIped ® brace (3TO GmbH, Deisenhofen, Germany), or a combination of COMBIped ® and an adhesive device, Podofix ® nail braces (3TO GmbH, Deisenhofen, Germany). 2 For patients with large granulation tissue, Podofix ® or cotton tamponade was initially applied for 2-4 weeks and oral antibiotics were prescribed for one week to wait for granulation tissue resolution, followed by COMBIped ® nail brace application. Patients were followed up on a monthly basis during the treatment period.…”

“…We classified the ingrown toenails into two clinical types: Acute inflammed infected-type and chronic dystrophic type ingrown toenails according to our previous studies. 1,2 Acute inflamed ingrown toenails were graded using the Heifetz staging. 9 The follow-up period referred to the brace-free period between nail brace removal (end of the treatment) and January 31, 2019.…”

“…Nail brace application has been used as a noninvasive and effective option for treating ingrown nail, [1][2][3][4][5] showing good efficacy for ingrown toenails of both the hallux 1,2,4,6 and the lesser toes. 7 In a prospective study, up to 95% of patients treated with nail braces showed major improvement, reduced pain and high patient satisfaction.…”

“…7 In a prospective study, up to 95% of patients treated with nail braces showed major improvement, reduced pain and high patient satisfaction. 2 However, recurrence rates vary between 7.4% and 28%. 2,3,5 Some patients even experience temporal deterioration of the condition during nail brace therapy which makes the disease difficult to control.…”

“…2 However, recurrence rates vary between 7.4% and 28%. 2,3,5 Some patients even experience temporal deterioration of the condition during nail brace therapy which makes the disease difficult to control. 1,8 In this study, we aimed to investigate the risk factors for poorly controlled and recurrence-prone cases of ingrown toenail treated with nail braces.…”