Comparative efficacy of S-shaped partial nail fold resection combined with lateral groove reconstruction and matrix phenolization on onychocryptosis: a retrospective study

Abstract

Abstract Background: Onychocryptosis is a pathologic condition and accounts for many clinical consultations. Selection for a suitable and effective treatment is crucial according to patients’ particular situation. To compare the efficacy and safety of S-shaped partial nail fold resection combined with lateral groove reconstruction versus matrix phenolization in patients with onychocryptosis. Methods: A total of 107 onychocryptosis participants at stage IIb and III were divided into 2 groups: 75 nails of 73 patients were treated with S-shaped partial nail fold resection combined with lateral groove reconstruction (S-shaped group) and 42 nails of 34 patients were treated with matrix phenolization (Phenol group). Clinical cure rate and post-surgery complications were evaluated. Besides, the new procedure was performed in 31 nails of 29 participants at stage IV in order to evaluate its efficacy. Results: After 6 months, in the remain 102 patients (110 nails), there was no statistically significant difference in clinical cure and satisfaction between two groups (P = 0.62 and 0.506, respectively). Fewer patients showed complications, including narrowed nail width and onycholysis, in the S-shaped group than the Phenol group (5.88 % vs. 45.2 %, P < 0.001). Besides, shorter healing time was observed in S-shape group (13.5 ± 1.4 vs 27.6 ± 2.3 days, P < 0.001). Postoperative pain was obvious in the S-shape group at the first postoperative day (P < 0.001), while a clear decrease in pain score was observed at 2 weeks after surgery (P = 0.407). Moreover, this nail-sparing surgery was successful used in stage IV patients with 100% cure rate. Conclusion: The new surgery has both benefits and drawbacks. The advantages are normal width nail plate and short healing time. The drawbacks are severe postoperative pain and complicated in operation. Therefore, matrix phenolization is recommended to cases at stage IIb and III, our new surgery is recommended to those patients with high demands of esthetic. Additionally, our new surgery is suitable to stage IV patients, with hypertrophic tissue completely covers lateral, medial, and distal nail plate.