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.

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.