Clinical and Sociodemographic Characteristics of Patients with Ingrown Nails.

BACKGROUND: Ingrown nail is a common health problem that significantly affects daily life due to its painful nature. The purpose of this study was to reveal the clinical and sociodemographic characteristics of ingrown nails. METHODS: The clinical and sociodemographic characteristics of patients older than 18 years presenting with ingrown nail were investigated. RESULTS: Two hundred six patients aged 18 to 77 years (mean age, 39 years; female to male ratio, 1.45) were included in the study. A total of 729 lesions were evaluated (718 ingrown nails were on the feet and 11 were on the fingers). A family history of ingrown nail was present in 7.6% of the participants. Of the 206 patients, 26.7% were treated with surgical methods for ingrown nails previously and experienced recurrence. Ingrown toenails were in the hallux in 81.3% of patients, and 52% were on the lateral margin. Incorrect nail-cutting habits (73.5%), poorly fitting shoes (46.2%), excessive angulation of the nail plate (35.8%), obesity (34.1%), trauma to the feet (24.3%), pregnancy (23.8% of women), hyperhidrosis (16.8%), and lateral deviation of the nail plate (9.9%) were closely associated with ingrown nails. CONCLUSIONS: This study revealed the clinical and sociodemographic characteristics of ingrown nails. The study data will be useful in preventing the development of ingrown nail and recurrences after treatment by identifying and then eliminating conditions establishing a predisposition to it.

A new onychocryptosis classification and treatment plan.

Onychocryptosis is a pathologic condition of the nail apparatus in which the toenail damages the nail fold. It is a common condition provoking pain, inflammation, and functional limitation. It principally occurs in the hallux. Onychocryptosis is one of the most frequent complaints regarding the foot and accounts for many clinical consultations. The disorder has been classified in terms of the stages of the pathologic condition. In our practice, we discovered a clinical entity that was not previously classified in the literature. We classify onychocryptosis into stages I, IIa, IIb, III, and the new stage IV. A treatment plan is offered for each stage of this classification, with both general and specific indications given. In onychocryptosis treatment, it is important to select the surgical technique best suited to the patient's particular clinical situation.

Wedge excision of the nail fold in the treatment of ingrown toenail.

Many treatment modalities of ingrown toenail are reported in the literature, often associated with unacceptably high recurrence rate. The authors present their technique, which aims at reducing the convexity of the nail fold. After complete removal of the nail plate and accurate debridement of the granulomatous tissue, a wedge-shaped ellipsis of skin and subcutaneous tissue, lateral to the affected nail fold, is removed. Approximation of the margins of the resulting defect determines eversion of the nail fold. One hundred twenty ingrown toenails were treated with the wedge excision of the nail fold at the outpatient clinic of the department of plastic surgery, Campus Bio-Medico University, Rome, Italy, between January 1998 and January 2002. Six recurrences were observed. In addition to the high cure rate, short postoperative pain duration, and morbidity as well as low risk of postoperative infection, the remarkable esthetic results achievable with this method are indicated.

[Taking a biopsy, treating ingrown nails. Minor nail surgery in general practice]. / Biopsien entnehmen, eingewachsene Nägel behandeln. Kleine Nagelchirurgie in der Praxis.

Prior to any surgical operation on fingernails or toenails a diagnosis, or at least a suspected diagnosis, must be established. Suitable material for histopathology can be obtained by various methods: lateral longitudinal biopsy, matrix biopsy, and nail bed or nail wall biopsy. Of the surgical options, nail extraction is rarely indicated, and if at all, should be only partial. In the presence of trauma, a careful examination should be made for fracture of the terminal phalanx; where necessary, the matrix and bed must be sutured. Advanced onychogryposis is treated by applying carbolic acid to the matrix. In the case of ingrown toenails and, where applicable, "tubular nails", surgical nail paring is indicated whenever conservative measures fail.

The Mozena Classification System and treatment algorithm for ingrown hallux nails.

Infected ingrown toenails raise the question of how much nail should be removed and what amount of nail fold reduction should occur. Often, the ungual labia folds are found to be hypertrophic, forcing the nail to push into the flesh and start a foreign body reaction. A simplified approach to this problem is proposed on the basis of the measurement of 100 normal nail folds and 25 infected nail folds. The results of this study show that the treatment goal should be to achieve an ungual labia fold of less than 3 mm, concluding that there is a correlation between the depth of the ungual labia fold and the severity of the infected ingrown toenail.

The treatment role of the plastic nail guard for ingrowing toenails.

An illustrative case of bilateral ingrowing toe-nails highlights the practical advantages of the use of the plastic nail guard (PNG). Insertion of the PNG is inexpensive and is easy to learn and perform. The technique is described and discussed. Its recurrence rate compares favourably with simple avulsion and wedge resection.

Ingrown nails: a comparison of the nail matrix phenolization method with the elevation of the nail bed-periosteal flap procedure.

Seventy-five procedures were performed on 62 patients with ingrown nails from 1992 to 1996. Those consisted of 51 nail matrix phenolization methods (NMP) and 24 elevation of the nail bed-periosteal flap procedures (ENF). Ingrown nails were classified into type A (normal nail plate) and type B (incurved nail plate). The duration and intensity of postoperative pain were assessed, and the recurrence rate was monitered. The recurrence rate was 3.9% in the NMP group and 4.1% in the ENF group. Concerning the recurrence rate, there was no statistical significance between ENF and NMP in both types. Postoperative pain intensity was less in the NMP group than in the ENF group in both types (P < 0.01). The same tendency was seen in postoperative pain duration. However, the NMP group had longer duration of wound healing compared with the ENF group in type A (P < 0.01). We conclude that NMP is a recommendable treatment for most ingrown nails.