Is There a Relationship Between Forefoot Alignment and Ingrown Toenail? A Case-Control Study

Abstract

Biomechanical imbalance between the hallux and the second toe and external compression of the lateral nail fold are proposed as the main reasons for ingrown toenail. Therefore, any anatomical predisposition facilitating this compression may play a role in the occurrence of ingrown toenail. The purpose of this study is to investigate the relationship between forefoot alignment and ingrown toenail. The authors retrospectively reviewed radiographs of 81 patients with ingrown toenails and compared them with 100 healthy subjects regarding forefoot alignment. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and interphalangeal angle (IPA) were measured, and feet were classified according to digital formula as Egyptian, Greek, and square. The mean HVA was 14.5° ± 5.0° in the case group and 13.2° ± 5.9° in the control group. The mean IMA was 9.1° ± 2.5° in the case group and 8.6° ± 3.1° in the control group. The mean IPA was 11.9° ± 4.1° in the case group and 12.0° ± 5.1° in the control group. There was no statistically significant difference between the groups regarding HVA, IMA, or IPA (P = .123, P = .198, and P = .925, respectively). The distribution of foot types between groups was also similar (P = .967). This study has failed to demonstrate any abnormality in forefoot alignment in patients with symptomatic ingrowing toenails, and it is suggested that treatment should not be based on the correction of the anatomy if no abnormality exists.

Epidemiology and bone‐related comorbidities of ingrown nail: A nationwide population‐based study

“…In fact, some studies have found that IN is associated with bone‐related comorbidities including phalangeal alignment, forefoot alignment and foot types . However, other studies revealed opposite results, and no association between bone alignment and IN …”

“…[4][5][6] However, other studies revealed opposite results, and no association between bone alignment and IN. 7 We conducted a population-based study using data from a nationwide representative sample cohort of over 1 million South Koreans. The aims were to investigate the epidemiology of IN in Korea and to clarify the association between IN and various bone deformities of the ankle and below the ankle joint.…”

Surgical management of ingrown toenails - an update overdue

“…A recent study failed to demonstrate any abnormality in the forefoot alignment in patients with symptomatic ingrowing toenails (4). The painful conflict between the plate and the periungual soft tissues may result from the following.…”

L’ongle incarné ou onychocryptose

“…De même, les malpositions d'orteils sont classiquement incriminées. Or, une étude récente de 100 cas appariés à des témoins n'a montré aucune corrélation entre malposition des orteils et ongle incarné [11]. En fait, il s'agit plutôt d'une cascade d'événements s'enchaînant et s'aggravant réciproquement.…”