Treatment of Ingrown Toenail With Proximolateral Matrix Partial Excision and Matrix Phenolization

Abstract

PURPOSE Ingrown toenail is one of the most common nail conditions. Although many surgical treatments are described for complicated cases, recurrence of pain and postoperative disability are common. We evaluated the long-term effi cacy of proximolateral matrix partial excision followed by chemical matricectomy with phenol. METHODSWe performed 348 proximolateral partial matricectomies and phenol ablations in 225 patients with stage 2 or 3 ingrown toenail. Patients were examined weekly until full wound healing was achieved and were observed for 24 months to assess the long-term effi cacy of the treatment.RESULTS Short-term results were good. We observed only 1 recurrence during the 24-month follow-up period, at 8 months. The success rate was therefore 99.7%. No severe complications occurred. Cosmetic results were remarkably good.CONCLUSIONS Proximolateral partial matricectomy with phenol ablation is an excellent surgical method for the treatment of ingrown toenails, having low morbidity and a high success rate, even in the long term.

Nail Braces as an Alternative Treatment for Ingrown Toenails: Results From a Comparison With the Winograd Technique

“…The 3 main stages of ingrown toenails were described by Heifetz (10) as follows: stage I (mild), swelling, erythema, slight edema, and pain with pressure; stage II (moderate), swelling, seropurulent exudates, nonhealing wound and oozing, infection, and granulation tissues; and stage III (severe), chronic inflammation, granulation, and chronic induration of the lateral nail fold (3,8). Fluctuation can exist between the stages, depending on the patient's care of the ingrown toenail (8).…”

“…All these have variable rates of recurrence (2,5,7,15). Surgical approaches have been reported as the best option for treating stage II and III ingrown toenails, because conservative approaches, which have positive results for stage I, result in greater rates of failure and recurrence (1,3,7,11,15,16). It is important to note that a consensus on the best surgical technique for the treatment of ingrown toenails has still not been reached (1,8,17).…”

“…It is important to note that a consensus on the best surgical technique for the treatment of ingrown toenails has still not been reached (1,8,17). A combination of surgical techniques, such as partial nail plate avulsion and chemical cauterization or wedge excision and phenol cauterization, was reported to be the best approach for treating ingrown toenails (1)(2)(3)11,17). In our study, we compared 2 treatment techniques: a very simple conservative treatment method, the nail brace, and a frequently performed, easy and standard procedure that requires no special equipment or chemicals, the Winograd technique.…”

Patient-Controlled Taping for the Treatment of Ingrown Toenails

“…[7][8][9][10] Many patients experience relapse or worsening of ingrown toenails, however, and many visited our clinic after having had primary treatment, especially with excision, elsewhere.…”

In This Issue: Through the Lens of a Clinician

“…6 The Annals editors thought that, were we to adopt this procedure, we would probably substitute local anesthetic without a vasoconstrictor, recognizing that it is common practice in the United States not to use epinephrine in digital blocks.…”