Short-Term Surgical Outcome of the Partial Nail Extraction in Ingrown Nail of Military Trainee: Is Matrixectomy Necessary? / 대한족부족관절학회지

PURPOSE: An ingrown nail is common in military trainees who are exposed to highly demanding activities. Although the matrixectomy procedure has been the main treatment modality, several drawbacks may follow after the procedure, such as infection, periostitis, and continued pain that causes a delayed return to duty. This study examined the outcomes of a simple partial nail extraction with the hypothesis that this procedure may bring an earlier return to duty, lower the perioperative complications, and produce a comparable recurrence rate. MATERIALS AND METHODS: The medical records of patients who had surgical treatment for an ingrown nail in the authors' institution between April 2016 and December 2017 were reviewed retrospectively. Under the inclusion and exclusion criteria, 28 patients with a simple partial nail extraction (group A) and 29 patients with a partial nail extraction with matrixectomy (group B) were investigated. As the clinical outcome, the visual analogue scale (VAS) and satisfaction score, time to return to duty, complications, and recurrence rate were checked and compared between the groups. RESULTS: The VAS scores of group B were significantly higher during the first (p<0.001) and second (p=0.026) follow-up week than group A. The time to return to duty was shorter in group A (7.8 days) than group B (10.1 days), and this difference was significant (p<0.001). Group B had five patients with complications, whereas group A had none (p=0.028). No differences in the recurrence rate (p=0.197) and patient satisfaction (p=0.764) were found between the groups. CONCLUSION: In this study, simple partial nail extraction in military trainees resulted in lower postoperative pain, lower complication rates, and earlier return to duty than the procedure with matrixectomy. Military trainees are temporarily exposed to highly demanding activities. Thus, a satisfactory outcome would be expected with simple partial nail extraction without performing a radical procedure, such as a matrixectomy.

Treatment of Ingrowing Toenails: Comparision of Surgery and Conservative Method Using Memory Alloy / 대한피부과학회지

BACKGROUND: Many techniques for the treatment of ingrown toenails have been described in the medical literature. Surgical removal of the nail plate with partial matricectomy is associated with the lowest recurrence rates. Shape-memory alloy (KD wire) has shown promising results for the treatment of ingrown toenails. However, the results of long term follow-up or a comparison with surgical treatment have not been reported, and the adequate removal time of the wire remains unknown. OBJECTIVE: To compare the results of surgical treatment using partial matricectomy (PM) to those of conservative treatment using KD wire (KD) and to determine the adequate removal time of the wire. METHODS: The KD and PM groups were compared regarding pain relief, quality of life improvement, pain and discomfort during the procedures and 3 weeks after, improvement of nail index by using clinical photos, and patient's satisfaction with the treatments. The nail index improvement in the KD group was compared between postprocedural days 14 and 21. RESULTS: Recurrence was higher (p=.039) in KD group (18.64%) than PM group (6.35%). Patient satisfaction was significantly better (p=0.025) in the PM group than in the KD group. Other parameters showed no significant differences between the two groups. Nail index improvement in the KD group was not significantly different between postprocedural day 14 and day 21. CONCLUSION: Conservative treatment using the KD wire is as effective as surgical removal with partial matricectomy for the treatment of ingrown nails in pain relief, QOL improvement and nail index improvement, but has higher recurrence. The adequate application period of KD is 2 weeks.

Success Rates of Multiple Treatments for Ingrown Nails / 대한피부과학회지

BACKGROUND: An ingrown nail is a common condition of inflammation and infection that can occur when nails are clipped too much or pressure is applied by tight shoes. In Korea, a study on the success of tube insertion after nail guttering has been reported, but studies including other treatments are lacking. OBJECTIVE: To evaluate the success rates of three treatments for ingrown nails: 1) nail splinting via a flexible tube; 2) partial nail extraction and electrocautery; or 3) partial nail extraction and phenol cauterization. METHODS: Fifty-one patients who underwent nail splinting via a flexible tube or partial nail extraction followed by either electrocautery or phenol cauterization of the nail matrix over a 6-year period at our hospital were evaluated for treatment outcome. The disease severity was classified using the Heifetz grading scale. We evaluated the success rates of the various treatments according to reduced disease severity. Treatment failure was defined as persistence or re-occurrence of disease symptoms. RESULTS: 1. Out of 51 cases of ingrown nails, 31 (60%) showed no recurrence after treatment. 2. There were conflicting results between the severity grade and success rate. 3. Treatment via partial nail extraction and either electrocautery or phenol cauterization was more effective (success rates of 63% and 60%, respectively) than nail splinting via a flexible tube (56% success rate). However, the results were not statistically significant. CONCLUSION: Selecting the proper therapeutic method is important for successful treatment of an ingrown nail.

Tratamento de disfunções ungueais com órteses / Treatment of nail disorders using orthesis

Neste artigo abordaremos causas comuns de afecções ungueais que causam dor: a hipercurvatura transversa da unha (HT) e a onicocriptose.A primeira tem como etiologia principal o fator hereditário e deformidades dos artelhos, enquanto a segunda também pode estar associada à má poda das unhas e uso inadequado de calçados.Tanto a HT quanto a onicocriptose podem advir de disfunções na biomecânica da marcha. Uma HT pode evoluir para onicocriptose e por isso seus tratamentos muitas vezes são semelhantes, tanto cirúrgica quanto conservadoramente.Dentre os tratamentos, este artigo enfoca o conservador, particularmente a aplicação de órteses ungueais, suas indicações e eficácia.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.

A Study of Nail-splinting Technique with Flexible Plastic Tube in Ingrown Nail / 대한피부과학회지

BACKGROUND: Ingrown nail is a common disorder that occurs most frequently in the great toe and gives affected patients a great discomfort. Many treatments hae been described, such as nail extraction, partial matrix phenolization and wedge excision. However, these treatments modality may lead to damage of the nail and nail fold or to frequent relapses. OBJECTIVE: We attempted to determine the effectiveness of nail-splinting technique with flexible plastic tube in ingrown nails. METHODS: Twenty-nine consecutive patients were treated and enrolled in this study. Without local anesthesia, the lateral edge of the nail plate including the spicule is splinted with a lengthwise -incised small flexible plastic tube, for example, plastic drainage portion of scalp vein set. The plastic tube retained for 2 weeks without any medication. RESULTS: Among the 29 patients, 24 patients were treated successfully without recurrence. After splinting, the patients experienced relief of pain immediately or 1~2 days later, therefore patients are able to lead ordinary lives more qvldrly. CONCLUSION: Nail-splinting technique with flexible plastic tube in ingrown nails is an effective treatment with relatively low recurrence rate. This method demands little skill and carried out in general practice. It gives an excellent cosmetic result with immediate pain relief, thus fulfilling the main requirements for the primary treatment of choice.