Surgical management of ingrown toenails - an update overdue

Abstract

For decades, every year sees a wide number of articles about treatment of ingrown toenails. There is still a debate about the cause of this painful condition. Surgical treatments rely on two main approaches: either narrowing the nail plate or debulking the soft tissues. It is up to the surgeon to select the most appropriate approach in each case. All procedures cited in this article have high cure rates as long as they are properly performed. As with all surgical procedures, they are operator dependent. Chemical cautery is the easiest and most versatile technique that may help in almost all instances for lateral ingrowing. For distal embedding and very hypertrophic and exuberant lateral folds, debulking with secondary intention healing is the most effective and easy to perform, with great results.

Best Way to Treat an Ingrown Toenail

“…The Howard-Dubois procedure is the best technique for mild to moderate cases, 1 whereas the super U procedure is best for severe cases. 17…”

“…7 Surgical treatment is indicated either when conservative treatments have failed or in moderate and severe cases. 1 For cases in which nail is responsible for the ingrown toenail, the definitive narrowing of the nail plate is preferred. When the condition is caused by hypertrophy of nail folds, debulking of the periungueal soft tissues is performed.…”

“…An imbalance between the widths of the nail plate and the nail bed and the hypertrophy of nail folds are considered to be the causes. 1 A large number of articles on the conservative treatment of ingrowing toenails have been described. [2][3][4][5][6] Techniques such as massaging the nail folds, taping, gutter splinting, and orthesis may help in the treatment of ingrowing nails, especially in mild cases and in children.…”

“…When the condition is caused by hypertrophy of nail folds, debulking of the periungueal soft tissues is performed. 1 This article describes the best surgical treatment of ingrowing toenails.…”

L’ongle incarné ou onychocryptose

“…Des périostites ont été imputées au curetage de la phalange, préalablement à l'application du phénol, ce qui est contre-indiqué. Dans les techniques s'adressant aux tissus mous, désunion, sphacèles et dysesthésies sont possibles [1][2][3][4].…”