Abstract Ingrown nails mainly affect the great toes, much less frequently lesser toes and rarely fingers. There are many speculations as to their etiology and pathogenesis; however, at the end, there is almost always a imbalance between too wide the nail plate and too narrow the (distal) nail bed. Ingrown nails occur at all age periods, from newborns to the over-100s though with different frequency, clinical characteristics, and management options. In recent years, conservative treatment options – taping, packing, gutter, braces, and many more - were developed avoiding the often disfiguring results of inadequate surgery. However, they require consistent and long-term therapy. Surgery is either aimed at narrowing the wide nail plate or reducing the hypertrophic lateral nail folds. The number of operation methods is vast; already 150 ago, more 75 different surgical techniques had been known, and there is virtually a new one published every week. Despite ingrown nails being a matter of concern for medical doctors since antique, new aspects continue to be detected, such as retronychia. Further, it was found that orthopedic foot abnormalities are very frequently seen in association with ingrown nails. Their treatment is often necessary to prevent recurrences.
Nails, Ingrown

BACKGROUND: Ingrown toenail is one of the most common nail complaints. It occurs mostly on the great toes, where is an excessive lateral nail growth into the nail fold, leading to painful irritation, inflammation, and growth of the granulation tissue. Many treatments have been described, but these classic treatment modalities may lead to severe damage of the nail fold or frequent relapses. OBJECTIVE: We attempted to evaluate the therapeutic efficacy of super elastic wire (SE-wire, Machiwire(R)), a non-invasive treatment for ingrown toenails. METHODS: Fifteen patients with ingrown toenail were treated with super elastic wire. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail root). Subjective assessment was evaluated by use of a visual analogue scale declared by patients. In addition, wound complications and recurrence were described. RESULTS: The width index and height index were improved (width index: 75.0%-->90.0%, height index: 76.5%-->27.7%). Pain was relieved in 100% of the cases. For subjective assessment, all of the patients were satisfied (more than "satisfactory": 100%). There were two relapsed cases during 5 to 12 month period (mean time: 9 months). CONCLUSION: We recommend super elastic wire method as an alternative treatment for ingrown toenail, because it is simple, easy to perform, noninvasive, effective, and well-tolerated.
Granulation Tissue ; Humans ; Inflammation ; Nails ; Nails, Ingrown ; Recurrence ; Toes

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.
Anesthesia, Local ; Coinfection ; Humans ; Lasers, Gas ; Nails ; Nails, Ingrown ; Phenol ; Quality of Life

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.
Anesthesia, Local ; Coinfection ; Humans ; Lasers, Gas ; Nails ; Nails, Ingrown ; Phenol ; Quality of Life

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.
Alloys* ; Follow-Up Studies ; Memory* ; Nails* ; Nails, Ingrown ; Patient Satisfaction ; Quality of Life ; Recurrence

BACKGROUND: Ingrown toenail is a common disorder that occurs most frequently in the big toe and gives affected patient great discomfort and pain. Granulation tissue of nail wall results from ulceration and inflammation by excessive contact between the nail edge and the soft tissues of the nail wall and induces aggravation of the ingrown toenail. OBJECTIVE: To decide whether removal of granulation tissue by electrocautery or not with lateral nail avulsion and matricectomy is the effective treatment in ingrown toenails with granulation tissue. METHODS: Randomized clinical trial with 12 month follow-up evaluations performed by observers. 33 patients with a total of 37 ingrown toenails were treated partial nail avulsion followed by mastricectomy and removal of granulation (granulation removal group), and 36 patients with 40 ingrown toenails were treated without removal of granulation tissue (control group). The determinations of effectiveness were based on the recurrence rate, duration of post-operative pain, wound healing time and post-operative infection. RESULTS: There was no significant difference in recurrence rates between the granulation removal group (15%) and control group (22%). There was a significant difference in the wound healing time between the granulation removal group (13.8 days) and control group (17.6 days). But there were no significant differences for the duration of post-operative pain and post-operative infection between the two groups. There were correlations between recurrence and duration of post-operative pain, wound healing time and post-operative infection. CONCLUSION: Procedures with granulation removal are an effective treatment for the treatment of ingrown nails, with the tendency of shorter times to reach complete recovery. But the effect of granulation removal has limited effect on reducing recurrence.
Electrocoagulation ; Follow-Up Studies ; Granulation Tissue ; Humans ; Inflammation ; Nails ; Nails, Ingrown ; Recurrence ; Toes ; Ulcer ; Wound Healing

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.
Cautery ; Electrocoagulation ; Humans ; Inflammation ; Korea ; Nails, Ingrown* ; Phenol ; Recurrence ; Shoes ; Splints ; Treatment Failure ; Treatment Outcome

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.
Anesthesia, Local ; Drainage ; General Practice ; Humans ; Nails, Ingrown* ; Phenol ; Plastics* ; Recurrence ; Scalp ; Splints ; Toes ; Veins

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nails ; pathology ; surgery ; Nails, Ingrown ; pathology ; prevention & control ; surgery ; Recurrence

PURPOSE: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. MATERIALS AND METHODS: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. RESULTS: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. CONCLUSION: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.
Adhesives ; Adolescent ; Anesthesia, Local ; Female ; Humans ; Medical Records ; Methods ; Nails ; Nails, Ingrown ; Plastics ; Recurrence ; Retrospective Studies ; Splints* ; Sutures ; Toes*