Ingrown toenail – an update of knowledge and a proposal of a novel treatment approach

Abstract

Ingrown toenail is one of the most common foot health problems, which is the reason for frequent paediatric, surgical, family medicine and podology appointments. The problem most often affects schoolchildren and young adults, with incorrect hygiene habits and improper care typically considered its causes. The disorder is usually managed in a surgical clinic, with a wedge-shaped undercutting of the nail plate or, in advanced cases, total nail avulsion, being the most common treatment approaches. However, these techniques are characterised by poor efficacy and high recurrence rates, and often lead to further complications, as well as permanent deformations of the nail plate. Therefore, we propose an alternative approach to the problem of ingrown toenails and present a causative surgical method. This technique consists in soft tissue plasty to reduce the prominence of nail folds followed by adaptation of healthy tissues with the use of skin sutures to the shape and dimensions of the nail plate. Since the procedure is performed under local anaesthesia, the treatment can be performed in an outpatient setting. Nail fold plasty allows for effective and permanent resolution of ingrown toenail symptoms, however, it requires strict compliance with postoperative recommendations, which mainly focus on proper care. The lack of interference in the structure of the nail matrix and plate minimises the risk of complications, permanent deformations of the nail apparatus and allows for maintaining the full width of the nail plate.