www.foothealth.co.za

INGROWN TOENAILS

Ingrown toenails or onychocryptosis, is a commonly encountered
problem in podiatry practice. Patients usually present with moderate pain
in the affected toe, however, with progression, infection, severe pain
and even difficulty walking or playing sports can occur. A lot of people
tolerate chronically ingrowing nails, but this should be a thing of the past.
Modern podiatrists are well trained in the latest surgical techniques to
treat ingrown nails and can offer great pain relief permanently.

Possible causes of ingrown toenails include improperly trimmed nails or
“picking at nails”, hyperhidrosis or sweaty feet, poorly fitting footwear,
trauma (kicking sports etc), abnormal nail shape (e.g. involuted nails),
obesity, or excessive external pressure. These alterations cause the nail
to improperly fit into the lateral nail groove, producing swelling and
inflammation of the lateral nail fold.

Treatment:
Although many treatment modalities are used including conservative nail
trimming, loose footwear and antibiotics, surgical nail wedge resections with
phenol matrixectomy remains the definitive treatment for ingrown nails.

A Partial Nail Wedge Resection (NWR) is a minor procedure that permanently removes a section of nail plate.
Basic steps to this procedure are

1. Informed consent is attained
2. Local anaesthetic is skilfully administered so the procedure is pain free
3. In a sterile environment, the offending section of nail is removed and the nail matrix/root is burnt using a
     chemical technique. This prevents the section of nail from regrowing.
4. A thick, absorbent aseptic dressing is applied and the anaesthetic will be effective for just long enough for the
     patient to get home comfortably and settled.
5. No sutures (stitches) are required, and therefore in most cases minimal pain is experienced post-operatively
6. The patient will be required to return for couple of dressing changes and a final check, normally at 48 hours
     post-op and then at one week.
7. Healing time is rapid, with full recovery usually within 3 – 6 weeks. Closed footwear should be avoided on
     the day of the surgery, but there are few other side effects. Most people can return to work the following day.