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Background: Nail braces are reportedly effective for treating both acute inflamed and chronic dystrophic type ingrown toenails. Aims: In this study, risk factors for poorly controlled and recurrence-prone ingrown toenails treated with nail braces were identified. Methods: We performed a retrospective study on patients with ingrown toenails between June 1, 2015, and May 31, 2018. The last follow-up date was January 31, 2019. Multivariate logistic regression was performed to evaluate the possible factors associated with poorly controlled status (ongoing paronychia during treatment) and recurrence. Results: There were 120 (244 sides) and 118 patients (167 sides) with chronic dystrophic and acute inflamed type ingrown toenails, respectively. The mean treatment duration and follow-up period were 161.2 ± 98.3 days and 432.7 ± 320.9 days, respectively. Poor control and recurrence were seen in 7.3% (17/232) and 12.2% (27/221) of the patients, respectively. In the multivariate analysis, acute inflamed ingrown toenails, previous nail avulsion, proximal nail fold hypertrophy and more than one affected side remained significantly associated with poorly controlled ingrown toenails. Foot bone deformity was significantly associated with recurrence. Limitations: This study was a retrospective study so that confounding factors such as comorbidities, body mass index, accompanying nail changes and lifestyle could not be evaluated. Conclusion: Several risk factors related to poor control and recurrence were identified. Patients could therefore benefit from more suitable treatment plans with reasonable expectation.
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Objective:To investigate clinical efficacy of nail removal in combination with periungual dermis-fat flap tamponade in the treatment of bilateral severe curved ingrown nails.Methods:A retrospective analysis was conducted on clinical data collected from 7 patients with bilateral severe curved ingrown nails visiting the hospital between January 2018 and January 2020. There were 3 males and 4 females, aged 25-49 years (average: 35 years) . All patients were treated with nail removal in combination with periungual dermis-fat flap tamponade at outpatient clinics.Results:All the 7 patients experienced primary healing of incisions without infections, and achieved pain relief 1-2 weeks after surgery. During the follow-up of 12 to 24 months, new nail plates grew back without curling deformity, no erythematous swelling occurred in the nail grooves, and no recurrence of paronychia was observed. All patients were satisfied with the clinical efficacy.Conclusion:Nail removal in combination with periungual dermis-fat flap tamponade is effective for the treatment of bilateral severe curved ingrown nails.
ABSTRACT
INTRODUCTION@#Ingrowing toenail (IGTN) or onychocryptosis is not uncommon in children and adolescents. However, there is a dearth of evidence in the literature on the management of IGTN in this age group. This study aimed to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents.@*METHODS@#All children and adolescents who were treated for IGTN at our institution between 2010 and 2014 were included for this retrospective study. Demographic data, treatment prescribed and outcome at six months after presentation were analysed.@*RESULTS@#Overall, 199 patients were recruited. There were 123 (61.8%) boys and 76 (38.2%) girls. Median age was 14 years. Among 199 toes, 162 (81.4%) were treated nonoperatively, with nail care advice, topical antibiotics and daily cleansing. Only 37 (18.6%) toes were treated operatively. In the operative group, 23 (62.2%) patients underwent wedge resections, while the remaining 14 (37.8%) had total nail avulsions; for all patients, germinal matrices were preserved. At the six-month follow-up, there were 5 (3.1%) cases of recurrence in the nonoperative group when compared to 3 (8.1%) recurrences in the operative group.@*CONCLUSION@#We recommend that IGTN in children and adolescents be treated in the first instance by nonoperative methods. Operative options can be considered for resistant cases or in case of recurrence of IGTN.
Subject(s)
Adolescent , Child , Female , Humans , Male , Anti-Bacterial Agents , Therapeutic Uses , Hospitals, Pediatric , Nails , Nails, Ingrown , Drug Therapy , General Surgery , Recurrence , Retrospective Studies , Singapore , ToesABSTRACT
BACKGROUND: Ingrown toenail is one of the most common nail complaints. It occurs chiefly on the great toes, where there is an excessive lateral nail growth into the nail fold, leading to painful irritation, inflammation, infection, and growth of excessive granulation tissue. Many treatments have been described, but these classic treatment modalities may lead to severe damage of the nail fold or to frequent relapses. OBJECTIVE: We attempted to evaluate the therapeutic effect of nail splinting which is a noninvasive therapy for ingrown toenails. METHODS: A total of 64 patients(78 lesions) with ingrown toenails were enrolled in the study. The lateral edge of the nail plate including the spicule is splinted with a lengthwise-incised flexible plastic tube. The efficacy of nail splinting for ingrown toenail was assessed by analyzing the degrees of post-treatment pain and a recurrence rate. RESULTS: 1.The average age of the patients was 37 years old. There were 38 male patients(47 lesions) and 26 female patients(31 lesions). The right big toe was affected in 27 patients and the left big toe in 23 patients. Fourteen patients had both feet affected at the same time. 2.The pain all cleared in an average 2.3 days of treatment. Other problems such as redness, swelling and granulation tissue gradually decreased as time went by. 3.There was a 7.8% recurrence rate at six months after the procedure. CONCLUSION:We recommend nail splint as an alternative to traditional treatment for ingrown toenail because it is simple and easy to perform, noninvasive, effective, well tolerated, and does not require any special equipment.