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Skin Research and Technology : Official... Mar 2023The measurements of width index, height index, and curvature index were used for assessment of the curvature severity. Nevertheless, both sides of the nail root are...
BACKGROUND
The measurements of width index, height index, and curvature index were used for assessment of the curvature severity. Nevertheless, both sides of the nail root are buried subcutaneously, impossibility in measuring the width index correctly.
MATERIALS AND METHODS
We developed a technique to measure the index under high-frequency ultrasonography (HF-USG).
RESULTS
There was good agreement between the HF-USG index and the result examined after surgery.
CONCLUSION
The observation on HF-USG helps to distinguish between ingrown nail and pincer nail. The HF-USG index will be useful in the examination and measurement of nail roots buried subcutaneously or nail penetration under the hypertrophic lateral nail fold, and comparing the effectiveness among treatments for pincer nail objectively.
Topics: Humans; Nails; Nails, Ingrown; Nails, Malformed; Ultrasonography
PubMed: 36973987
DOI: 10.1111/srt.13306 -
Journal of Foot and Ankle Research Sep 2023When performing nail surgery, clinicians must choose from a multitude of procedures and variations within each procedure. Much has been published to guide this decision... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis of randomised controlled trials of surgical treatments for ingrown toenails part II: healing time, post-operative complications, pain, and participant satisfaction.
BACKGROUND
When performing nail surgery, clinicians must choose from a multitude of procedures and variations within each procedure. Much has been published to guide this decision making, but there are a lack of up to date robust systematic reviews to assess the totality of this evidence.
METHODS
Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence. Data on co-primary outcomes of symptom relief and symptomatic regrowth were presented in our first paper. This paper presents data for the secondary outcomes and further discussion.
RESULTS
Of 3,928 records identified, 36 randomised trials were included in the systematic review. Healing time appears to be reduced with shorter application of phenol. A reduced healing time was also apparent was with the addition of curettage, although this may also increase the risk of post-operative bleeding and pain. Post operative bleeding was also reportedly lower in people who received local anaesthetic with epinephrine but no tourniquet. Use of phenol with nail bed excision may decrease the risk of infection. Lower pain scores were reported when using partial matrixectomy and surgical interventions with phenol. Shorter duration of pain was reported with phenolisation and wedge resection. Participant satisfaction was high overall.
CONCLUSION
This second paper reports secondary outcomes from a robust systematic review of randomised trials on surgical treatment of ingrown toenails. Despite the large volume of clinical trials conducted on the topic, few clinical conclusions can be drawn due to the poor quality of these studies. Further high-quality clinical trials are needed to answer fundamental questions in the surgical treatment of ingrown toenails.
Topics: Humans; Nails; Postoperative Complications; Pain; Phenol; Nails, Ingrown; Phenols; Personal Satisfaction; Randomized Controlled Trials as Topic
PubMed: 37674170
DOI: 10.1186/s13047-023-00655-7 -
Acta Dermatovenerologica Alpina,... Mar 2020There are only two publications in Pubmed on the effectiveness of cryotherapy in ingrown toenails, and they present conflicting results. We aimed to clarify the clinical...
INTRODUCTION
There are only two publications in Pubmed on the effectiveness of cryotherapy in ingrown toenails, and they present conflicting results. We aimed to clarify the clinical effectiveness of cryotherapy in onychocryptosis.
METHODS
This study retrospectively examined the visual analogue scale (VAS), dermatological life quality index (DLQI), other medical records, and photographs taken before each cryotherapy session and 6-month follow-up in 59 adult patients with ingrown toenails that underwent cryotherapy with a 3-week interval. Cryotherapy effectiveness was assessed by the clinicians' decisions, improvements in VAS and DLQI scores, and granulation tissue. Other factors related to effectiveness and recurrence were also investigated.
RESULTS
After excluding approximately 20% of patients, for whom the treatment was not effective, this study revealed that recurrence rates in unilateral and bilateral onychocryptosis were 34.2% and 88.9%, respectively, 6 months after treatment. In patients that responded to the treatment, about 75 to 80% had excellent symptomatic responses. Excellent symptomatic responses were maintained in about 80% of patients in remission. We found that foot or toe deformity was associated with treatment ineffectiveness (p = 0.019). Age younger than 20 years and bilateral ingrown toenails were also related to recurrence (p = 0.042 and 0.003, respectively).
CONCLUSIONS
Cryotherapy can be used to greatly and consistently improve the DLQI in suitable ingrown toenails.
Topics: Adolescent; Adult; Aged; Cryotherapy; Female; Humans; Male; Middle Aged; Nails, Ingrown; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 32206817
DOI: No ID Found -
Dermatology Practical & Conceptual Jan 2018Our routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of...
BACKGROUND
Our routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of excision based on our experience without an objective standard and routinely performed avulsion of the nail plate.
OBJECTIVE
To take the nail plate as an objective mark during surgical treatment of ingrown toenail to ensure accurate excision.
PATIENTS AND METHODS
Fifteen patients with ingrown toenails were treated with this technique. We used the lateral borders of the nail plate as a landmark to determine the volume of soft tissue surrounding the nail plate and distal phalanx to be removed. No avulsion of nail plate was performed.
RESULTS
No recurrence was observed during the follow-up period, which ranged from 24 to 35 months (29.9 months on average). The visual analog scale for pain showed significant pain relief in the patients. The Vancouver Scar Scale showed acceptable cosmetic outcomes. The width of excised skin ranged from 3.5 to 6.2 mm (5.0 mm on average).
CONCLUSION
The use of the lateral borders of the nail plate as a landmark for surgical intervention of ingrown toenail offered excellent outcomes and reduced loss of healthy tissues.
PubMed: 29445570
DOI: 10.5826/dpc.0801a05 -
Indian Journal of Dermatology 2022According to the Mozena classification system, stage IIb and stage III ingrown toenail cases are considered as severe ones; however, limited options are available for...
BACKGROUND
According to the Mozena classification system, stage IIb and stage III ingrown toenail cases are considered as severe ones; however, limited options are available for treatment.
AIMS
To lower the recurrence rate and achieve primary intention healing in severe ingrown toenail cases by the modified Howard-Dubois technique.
METHODS
Forty patients were included in this study. In this procedure, a fish-mouth like soft tissue along the nail groove to the tip of the toe was resected, the upper surface of the distal phalanx was flattened and the nail bed matrix was remodelled. The European Quality of Life (EuroQol) questionnaire and Surgical Satisfaction Questionnaire were used to assess the outcomes.
RESULTS
There were no recurrences observed during the follow-up period. Healing time from surgery to back to school or work was 10.82 days on an average (range: 7-23 days). According to the results of EuroQol questionnaire, improvements were achieved in the areas of mobility (50%), looking after myself (10%), doing usual activities (35%), having pain or discomfort (95%) and feeling worried, sad, or unhappy (55%). According to the results of Surgical Satisfaction Questionnaire, 38 (95%) patients indicated that they would undergo the surgery again if they 'had to do it all over again' and 36 (90%) patients said that they would recommend the procedure to others.
CONCLUSIONS
This modified Howard-Dubois technique was an effective, safe and cosmetic alternation for the treatment of ingrown toenail in severe or relapsed cases.
PubMed: 36578757
DOI: 10.4103/ijd.ijd_687_21 -
International Journal of Environmental... Oct 2020Onychocryptosis is one of the most prevailing onychopathies and one of the usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the... (Randomized Controlled Trial)
Randomized Controlled Trial
Onychocryptosis is one of the most prevailing onychopathies and one of the usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the effectiveness of a procedure of nail reeducation technique via a strip of polyethylene in subjects with stage I or IIa onychocryptosis, in which pathological toenail curves are present. This research was a randomized clinical trial (ACTRN12615000834550). The sample was made up of 94 cases of stage I or IIa onychocryptosis, according to the Mozena classification. Briefly, 46 cases were treated with the combination of a spicule technique and nail brace with a polyethylene plastic strip, and 48 were only treated with the spicule technique. The combination of the spicule technique and the nail brace technique with a strip of polyethylene had a significantly lower recurrence rate compared to that achieved with just the spicule technique, twelve months after the beginning of the study (N.S. = 0.000 for α = 0.05). The change in the nail width achieved with the nail brace technique, twelve months after the beginning of the study, was statistically significant (N.S. = 0.000 for α = 0.05). The recurrence rate of the spicule technique alone was significantly higher than the combined technique of spicule with nail brace. A nail brace with a strip of polyethylene reduces the recurrence rate of onychocryptosis.
Topics: Braces; Humans; Nails; Nails, Ingrown; Polyethylene; Recurrence
PubMed: 33113886
DOI: 10.3390/ijerph17217741 -
Annals of Medicine and Surgery (2012) Aug 2020In the present study, we investigated the satisfaction of patients following sutured surgical treatment of an ingrown toenail with nail preservation and without...
BACKGROUND
In the present study, we investigated the satisfaction of patients following sutured surgical treatment of an ingrown toenail with nail preservation and without matricectomy.
MATERIALS AND METHODS
This study was retrospective. In total, 37 consecutive patients underwent 54 ingrown toenail surgeries. The clinical outcomes, satisfaction of surgery, recurrence rates and the duration of symptoms were compared.
RESULTS
Recurrence with the technique was very low (one toenail). The mean overall satisfaction score on the surgical satisfaction questionnaire was 86.4 ± 10.4 and extended with a modified esthetic subscale (88 ± 10). The mean pain subscale score was the lowest at 77.1 ± 16.8, while the subscale returns to baseline scored 80.9 ± 16.4, the subscale global satisfaction scored 98.1 ± 7.2 and the subscale esthetics scored 92.1 ± 15.
CONCLUSION
Our suturing technique was associated with low recurrence and high satisfaction rates. We showed that higher levels of satisfaction with the treatment were achieved in men, and the duration of symptoms was no longer than one year.
PubMed: 32637092
DOI: 10.1016/j.amsu.2020.06.029 -
Dermatology Practical & Conceptual Oct 2015Ingrown nail surgery is the one of the most common surgeries in outpatient clinics that are generally perfomed in response to patient complaints. Still, making simple...
Ingrown nail surgery is the one of the most common surgeries in outpatient clinics that are generally perfomed in response to patient complaints. Still, making simple observations, taking patient histories and conducting further tests are often neglected by outpatient clinics. Consequently, it is important to be aware if ingrown nail is associated with any underlying diseases that can lead to major complications. In this article, we report on two cases ending in amputation that were performed with Winograd's partial matrix excision procedure for ingrown nails. Such a complication is rare, unexpected, and most unwanted in forefoot surgery. After a detailed analysis of the situation, we discovered that both patients were smokers, and one of them had Buerger's disease. These conditions led to the ingrown nails in addition to poor wound healing. This case report emphasizes the fact that even when performing minor procedures, obtaining a detailed history and conducting an examination are of paramount importance. Patient selection is also a considerable factor, especially for patients who are smokers, who may experience a worst case surgical scenario.
PubMed: 26693080
DOI: 10.5826/dpc.0504a01 -
Journal of Cutaneous and Aesthetic... 2023Retronychia refers to the embedding of the nail into the proximal nail fold. Patients present with chronic paronychia in the setting of disrupted nail growth. Nail...
Retronychia refers to the embedding of the nail into the proximal nail fold. Patients present with chronic paronychia in the setting of disrupted nail growth. Nail avulsion is curative and unlike other forms of ingrown nails, it does not tend to recur. We report a case of retronychia who presented with pain and swelling around bilateral great toes. Further examination showed growth of overlapping nail plates, which led to the diagnosis of retronychia. This article emphasizes the clinical features and treatment options available for retronychia, thereby avoiding misdiagnosis.
PubMed: 38314366
DOI: 10.4103/JCAS.JCAS_71_21 -
Journal of Cutaneous and Aesthetic... 2020Ingrown toenails result from the painful conflict between the nail plate and the surrounding soft tissues. Ingrowing may be precipitated by improper nail cutting in most...
Ingrown toenails result from the painful conflict between the nail plate and the surrounding soft tissues. Ingrowing may be precipitated by improper nail cutting in most instances, and occlusive footwear and trauma, in others. The most common type of ingrown nail is the distal lateral variant. We report a relatively unique and rare case of ingrown nail-the harpoon nail, wherein the distal lateral spur arising from improper and incomplete trimming of the nail, pierced through the distolateral wall until it appeared over the tip of the toe. It is a cause of great morbidity to the patient and this report envisages the need for the correct surgical approach.
PubMed: 32792774
DOI: 10.4103/JCAS.JCAS_99_19