Ingrown toenails treatment in diabetic patients: a Pilot Study of a new conservative treatment of orthonyxia.

Abstract

Ingrown toenail (also onychocryptosis) is one of the most frequent nail pathologies in diabetic population. Neurological and vascular complications can increase painful symptoms and suffering of tissue which can lead to ulceration, therefore surgical matricectomy is not recommended. In this research we aim to evaluate the effectiveness of a 40% urea cream treatment associated whit nail acrylic resin brace (ortonixia) versus traditional cut and resin nail’s recostruction. Diameter of nail and NRS scale were used to evaluate change of nail plate and pain before and after treatment. 32 subjects with 52 treated nails were included. About 20 nails of 13 subject were recruited in experimental group. Differential final and initial diameter was 4.67±1,55 mm in experimental group and 3.01±1.26 mm in control group ( p<0.0001) and recurrence rate was 15% and 75% respectively ( p<0.0001). Also days of absence of pain, in experimental group there was a mean of 319.05±113.18 days, instead in control group there was a mean of 208.31±119.84 days (p<0.0002). This statistical analysis shows that effectiveness of new conservative approach is greater than in nail reconstruction method and a valid alternative to surgical treatment in diabetic patients.