• Archives of Plastic Surgery
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• 제50권3호
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• pp.274-278
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• 2023

Ingrown toenails are most common among school-age children and adolescents though they can be observed at any age. Causes of ingrown toenails are increased curvature, trauma, and external pressure. Treatment of ingrown toenails can be broadly characterized as conservative and surgical. Conservative treatment can be performed using various methods, such as a gutter splint, dental floss, and cotton. Surgical treatments may be divided into two main approaches; narrowing of the nail plate and debulking of periungual tissues. However, these various conservative and surgical treatments have high recurrence rates, and thus, the author used a permanent surgical method based on the use of a paronychium flap to treat a 15-year-old male adolescent with excessive periungual tissues and curved ingrown toenails who did not improve despite conservative and several surgical treatments over 4 years. Subsequently, toenail shape was maintained without recurrence 22 months after surgery, and there were no complaints of inflammation or pain while walking. This simple surgical method can be performed on patients with advanced ingrown toenails due to excessive periungual tissues and nail curvature and can be expected to have permanent effects.

• 대한족부족관절학회지
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• 제23권2호
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• pp.52-57
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• 2019

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.

• 대한족부족관절학회지
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• 제22권3호
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• pp.111-115
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• 2018

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.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.202-207
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• 2024

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively (p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively (p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

• Archives of Plastic Surgery
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• 제42권2호
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• pp.207-213
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• 2015

Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group ($14.0^{\circ}{\pm}3.6^{\circ}$) than in the control group ($7.9^{\circ}{\pm}3.0^{\circ}$) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.191-194
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• 2010

Treatments of severely incurved toenails cause anatomical changes and cosmetic problems, even though they provide adequate symptom relief. Incurved toenail patients treated with a K-D$^{(R)}$ (S&C Biotech, Seoul, South Korea) the new device for correcting curved nail deformity were investigated retrospectively. This study surveyed 12 patients(18 cases) who had been treated for severe ingrown toenails using K-D$^{(R)}$ from May 2008 to March 2009, and examined their subjective satisfaction before and after the treatment. The average age of the participants was 39 (ranging from 27 to 52), and 8 of them were male and 4 female. The treatment was applied after the patients were given a thorough explanation about the tool and the treatment, and questionnaire surveys were conducted before the treatment and after 3 months on the average from the treatment. In the survey, the respondents were asked about pain, restriction on activities, and the selection of shoes. For each item, symptoms with a given point were presented, and the respondents' scores were compared between the surveys before and after the treatment. According to the results of the questionnaire survey, pain increased from 14 out of 40 before the treatment to 39 after, activity restriction increased from 11 to 30, and shoe selection increased from 20 to 30. The average total score increased from 45 to 98, and this suggests a considerable enhancement in the patients' subjective satisfaction. The average period of the application of K-D$^{(R)}$ was $20.3{\pm}9.4$ days, and in all the cases, ingrown toenails were corrected within three weeks.

• 대한족부족관절학회지
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• 제15권3호
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• pp.139-143
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• 2011

Purpose: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. Materials and Methods: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was $14.0{\pm}1.3$ months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. Results: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was $73.1{\pm}12.8$, and it improved to $98.7{\pm}1.1$ by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from $53.3{\pm}12.9$ degrees to $18.2{\pm}7.4$ degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. Conclusion: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.

• 한국융합학회논문지
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• 제10권9호
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• pp.301-309
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• 2019

본 연구의 목적은 네일샵 이용자들이 네일샵 추천의도의 영향요인을 파악하는 데 목적이 있다. 연구대상은 수도권 10대~50대 남녀 305명의 설문자료를 수집한 뒤 불성실한 응답과 문제성 발톱이 없는 170명을 제외한 135명 자료로 활용하였다. 분석 결과 문제성 발톱유형에 따른 차이에서는 내성발톱이 통계적으로 유의한 차이가(F=5.588, p<.01), 발 관리 장소에 따른 차이에서는 발관리 행동은 홈케어(집)/민간요법/약국(F=4.319, p<.01), 문제성 발톱에 대한 네일샵 추천의도에서는 네일샵이 통계적으로 유의한 것으로 나타났다(F=15.152, p<.01). 또한 네일샵의 문제성 발톱케어 가능인지, 네일샵에서 문제성 관리여부, 발관리 행동, 전문성 인식에 따른 네일샵 방문의도가 네일샵 추천의도에 정적으로 유의한 영향을 주는 것으로 확인되었다(F=16.847, p<.001). 따라서 본 연구는 네일샵에서 문제성발톱 케어 인식도를 높이고, 문제성 발톱유형에 따른 개선 및 예방적용을 확장하는데 기초자료로 판단된다.