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American Family Physician Aug 2019
Topics: Humans; Nails, Ingrown
PubMed: 31361109
DOI: No ID Found -
Canadian Family Physician Medecin de... May 1983Ingrown toenails are commonly seen in family practice, and are treated conservatively. If this does not resolve the condition, lateral wedge resection and permanent,...
Ingrown toenails are commonly seen in family practice, and are treated conservatively. If this does not resolve the condition, lateral wedge resection and permanent, partial nail bed ablation are necessary. Recurrence can be prevented by chemical cautery with 10% sodium hydroxide. Betadine packing reduces infection.
PubMed: 21283372
DOI: No ID Found -
American Family Physician Jun 2002Ingrown toenail is a common problem resulting from various etiologies including improperly trimmed nails, hyperhidrosis, and poorly fitting shoes. Patients commonly... (Review)
Review
Ingrown toenail is a common problem resulting from various etiologies including improperly trimmed nails, hyperhidrosis, and poorly fitting shoes. Patients commonly present with pain in the affected nail but with progression, drainage, infection, and difficulty walking occur. Excision of the lateral nail plate combined with lateral matricectomy is thought to provide the best chance for eradication. The lateral aspect of the nail plate is removed with preservation of the remaining healthy nail plate. Electrocautery ablation is then used to destroy the exposed nail-forming matrix, creating a new lateral nail fold. Complications of the procedure include regrowth of a nail spicule secondary to incomplete matricectomy and postoperative nail bed infection. When performed correctly, the procedure produces the greatest success in the treatment of ingrown nails. Basic soft tissue surgery and electrosurgery experience are prerequisites for learning the technique.
Topics: Ambulatory Surgical Procedures; Humans; Informed Consent; Nails, Ingrown; Toes
PubMed: 12086244
DOI: No ID Found -
Der Hautarzt; Zeitschrift Fur... Apr 2014Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the...
Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the nail apparatus. Bowen disease is probably the most frequent nail malignancy. It is usually seen as a verrucous plaque of the nail fold and nail bed in persons above the age of 40 years. It slowly grows over a period of years or even decades before degenerating to an invasive squamous cell carcinoma. The latter may also occur primarily often as a weeping onycholysis. The next most frequent nail malignancy is ungual melanoma. Those arising from the matrix are usually pigmented and often start with a longitudinal melanonychia whereas those originating from the nail bed remain amelanotic, are often nodular and mistaken for an ingrown nail in an elderly person. The treatment of choice for in situ and early invasive subungual melanomas is generous extirpation of the nail apparatus whereas distal amputation is only indicated for advanced melanomas. In addition to these frequent nail malignancies, nail-specific carcinomas, malignant vascular and osseous tumors, other sarcomas, nail involvement in malignant systemic disorders and metastases may occur. In most cases, they cannot be diagnosed accurately on clinical grounds. Therefore, a high degree of suspicion is necessary in all isolated or single-digit proliferations that do not respond to conservative treatment.
Topics: Antineoplastic Agents; Bowen's Disease; Chemoradiotherapy; Diagnosis, Differential; Humans; Melanoma; Nail Diseases; Skin Neoplasms
PubMed: 24718507
DOI: 10.1007/s00105-013-2705-z -
American Family Physician Feb 2009Ingrown toenail, or onychocryptosis, most commonly affects the great toenail. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as... (Review)
Review
Ingrown toenail, or onychocryptosis, most commonly affects the great toenail. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. Conservative treatment approaches include soaking the foot in warm, soapy water; placing cotton wisps or dental floss under the ingrown nail edge; and gutter splinting with or without the placement of an acrylic nail. Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization. Electrocautery, radiofrequency, and carbon dioxide laser ablation of the nail matrix are also options. Oral antibiotics before or after phenolization do not improve outcomes. Partial nail avulsion followed by either phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toenails. Compared with surgical excision of the nail without phenolization, partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence of ingrowing toenails, but has a slightly increased risk of postoperative infection.
Topics: Humans; Nails, Ingrown; Toes
PubMed: 19235497
DOI: No ID Found -
Journal of Cutaneous and Aesthetic... 2023
PubMed: 37554686
DOI: 10.4103/JCAS.JCAS_125_22 -
Acta Orthopaedica Et Traumatologica... 2015The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This... (Comparative Study)
Comparative Study
OBJECTIVE
The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This study also aimed to determine the etiology of ingrown nails, whether due to involvement of the nail or soft tissue.
METHODS
Seventy-five patients with a total of 90 ingrown nails (stages 2 and 3) who presented at our clinic between 2012-2014 were included in this study. Patients were divided into 2 groups: those treated with the knot technique and those treated with the Winograd technique. Patients in both groups were evaluated for the amount of local anesthetic required, intraoperative pain, effectiveness of preventing/stopping hemorrhage, surgery time, complications, postoperative nail size, recurrence, nail deformities, and secondary surgery rates.
RESULTS
The mean surgical time, relapse rate, number of additional surgeries required, and amount of local anesthetic were significantly greater in the Winograd group than in the knot group. The mean nail diameter was significantly decreased, with a mean of 3 mm in the Winograd group. No statistically significant differences were found between the groups in the incidence of infection, intraoperative pain, hematoma, or nail deformity.
CONCLUSION
This study demonstrated that the knot technique, consisting of wedge excision of soft tissue without affecting the nail itself, is a simple technique to treat ingrown nails with a lower complication rate and shorter surgical time. We believe that successful treatment of ingrown nails depends only on excision of soft tissue, with no need to operate on the nail bed.
Topics: Adolescent; Adult; Anesthesia, Local; Female; Humans; Male; Middle Aged; Nails, Ingrown; Operative Time; Orthopedic Procedures; Postoperative Complications; Recurrence; Young Adult
PubMed: 26422350
DOI: 10.3944/AOTT.2015.14.0450 -
Dermatology Online Journal Jul 2017Retronychia is a recently described cause of ingrowth of the nail plate on the ventral surface of the proximal nail fold. Clinical features are repeated episodes of...
Retronychia is a recently described cause of ingrowth of the nail plate on the ventral surface of the proximal nail fold. Clinical features are repeated episodes of proximal paronychia, nail plate thickening, and occasionally granulation tissue emergence. The usual treatments for paronychia such as antibiotics and antifungals are ineffective in these cases. Avulsion of the nail plate is the treatment of choice for these patients, but effective treatment is usually delayed owing to inadequate diagnosis. Herein, we describe a 28-year-old woman with a case of retronychia. She was treated for two months with oral and topical antifungal and antibiotics by her general practitioner. After proper diagnosis and avulsion of the nail she presented a normal and non-painful growth of the affected nail.
Topics: Adult; Female; Hallux; Humans; Nails, Ingrown; Paronychia
PubMed: 29469707
DOI: No ID Found -
Australian Family Physician Mar 2015An ingrown toenail or onychocryptosis may occur at any age and is the mostly commonly encountered toenail problem likely to be seen in general practice. (Review)
Review
BACKGROUND
An ingrown toenail or onychocryptosis may occur at any age and is the mostly commonly encountered toenail problem likely to be seen in general practice.
OBJECTIVE
This article will discuss the common surgical approaches available for the management of an ingrown toenail.
DISCUSSION
Ingrown toenail can be a painful condition that can become infected and may require surgical treatment. The epidemiology of onychocryptosis is difficult to determine as it is often considered to be a minor medical problem and as such has been some-what neglected in the literature. The few studies that have been conducted suggest a slightly higher male-to-female ratio, particularly in the 14-25 age group,4 but it can affect patients of any age. There are multiple reasons why an ingrown toenail will develop, including improper nail cutting technique, tight-fitting footwear, trauma, anatomical factors such as thickening of the nail plate, pincer-shaped toenail, pressure from abutting digits caused by hallux valgus or lesser toe deformities, the presence of a subungual exostosis and, occasionally, the use of isotretinoin in the treatment of severe acne.
Topics: Disease Management; General Practice; Humans; Nails, Ingrown; Toes
PubMed: 25770573
DOI: No ID Found -
Foot & Ankle International Apr 2022
Topics: Humans; Nails
PubMed: 34749539
DOI: 10.1177/10711007211053864