Relationship between the presence of abnormal hallux interphalangeal angle and risk of ingrown hallux nail: a case control study

Abstract

BackgroundMany risk factors have been identified to be associated with ingrown toenail. Internal pressure by the distal phalanx of the hallux and the second toe and external compression from the shoes has been proposed as a reason for the pathology. The main objective of the study was to analyze the existence of a correlation between the presence of pathological hallux interphalangeal angle (HIA) and risk of ingrown hallux nail.MethodsOne hundred and sixty-five subjects (312 ft) were enrolled in a cross-sectional, analytical and observational case–control study. A radiographic computerized system was used to measure HIA in both groups. The angle was considered as the sum of three angles, obliquity, asymmetry and joint deviation.ResultsThe mean HIA in case group subjects (patients with hallux ingrown nail) was significantly higher than that obtained in control group subjects (17.39 ± 6.0° versus 13.47 ± 4.6°, p = .036). A total of 73.71 and 46.79 % of feet presented an angle equal or greater than 13.47° in the onychocryptosis and control group, respectively.ConclusionsThe results show a correlation between the variables analysed. The presence of an HIA greater or equal than 14.5° may be a predisposing factor for developing onychocryptosis of the hallux. Clinicians treating individuals with pathology in hallux might use a baseline cutoff of HIA equal than 13.5°.

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

“…In our study, valgus or varus deformities of AFT and the big toe, among acquired bone deformities, increased the risk of IN by more than 1.5 times over that in the control group. Previous studies also found an association of IN with the interphalangeal hallux angle . One pathogenic hypothesis of congenital malalignment of the big toe nail, which is a congenital or early developmental disorder affecting the nail plate alignment and commonly accompanied by hallux valgus, is that nail displacement is caused by increased tension by the extensor tendon of the hallux, pulling the lateral portion of the matrix proximally and resulting in longitudinal displacement of the nail plate axis.…”

“…Previous studies also found an association of IN with the interphalangeal hallux angle. 6 One pathogenic hypothesis of congenital malalignment of the big toe nail, which is a congenital or early developmental disorder affecting the nail plate alignment and commonly accompanied by hallux valgus, is that nail displacement is caused by increased tension by the extensor tendon of the hallux, pulling the lateral portion of the matrix proximally and resulting in longitudinal displacement of the nail plate axis. It is suggested that this may be a cause of IN associated with valgus or varus deformity of the hallux.…”

“…In fact, some studies have found that IN is associated with bone-related comorbidities including phalangeal alignment, forefoot alignment and foot types. [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.…”

“…In addition to this factor, it can be postulated that any bone abnormalities in the ankle, foot or toe that increase the internal pressure play a role in developing IN. 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 …”

The Treatment of Ingrown Nail: Chemical Matricectomy With Phenol Versus Aesthetic Reconstruction. A Single Blinded Randomized Clinical Trial

“…It is a common condition provoking pain, inflammation, and functional limitation [1]. There are numerous surgical procedures and modifications described in the surgery of ingrown nail [1][2][3][4][5], its causes, and contributing risk factors [6]. There exist various non-incisional surgical options, such as the gold standard procedure, chemical matricectomy with 88% phenol solution, and its modifications [7][8][9], such as the modification which eliminates cauterized tissue via thorough curettage [1], or different duration for the application time of phenol [10].…”