Comparison of Outcome of Ingrowing Toenail Surgery---Simple Nail Removal V/S Wedge Resection
DOI:
https://doi.org/10.51253/pafmj.v75i2.10311Keywords:
Ingrowing Toenail, Simple Nail Removal, Wedge Resection, OutcomeAbstract
Objective: To compare outcome of ingrowing toenail surgery---simple nail removal v/s wedge resection.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi, Pakistan, from Mar 2022 to Feb 2023.
Methodology: A total of 100 patients were enrolled and randomly divided into two equal groups. Group A cases were treated with simple nail removal whereas Group B was allotted Wedge resection. Both of these techniques were compared for operative time, recurrence of ingrowing toenail and post operative infection.
Results: The mean age of the patients in Group A was 37.86±9.33 years and in Group B, it was 41.08±7.59 years (p-value=0.061), while gender distribution showed that males numbered 29(58%) in Group A and 31(62%) in Group B whereas, females comprised 21(42%) in Group A and 19(38%) in Group B, (p-value=0.68). Mean operative time in Group A was 10.68±2.23 minutes and in Group B it was 10.30±2.67 minutes while recurrence was recorded as 2(4%) in Group A and 3(6%) in Group B. We found post operative infection in 1(2%) patient in both groups with p-value>0.999.
Conclusion: We found no significant difference in both techniques regarding recurrence, post operative infection, and operative time. However, simple nail removal is well tolerated, and does not present any technical challenges; hence, it ought to be regarded as an alternative to other techniques of treatment.
Downloads
References
Bryant A, Knox A. Ingrown toenails: the role of the GP. Aust Fam Physician 2015; 44(3): 102-105.
https://doi.org/10.31128/AFP-44-3-0002
DeLauro NM, DeLauro TM. Onychocryptosis. Clin Podiatr Med Surg 2004; 21(4): 617-630.
https://doi.org/10.1016/j.cpm.2004.05.006
Park DH, Singh D. The management of ingrowing toenails. BMJ 2012; 344: e2089.
https://doi.org/10.1136/bmj.e2089
Wollina U. Systemic drug-induced chronic paronychia and periungual pyogenic granuloma. Indian Dermatol Online J 2018; 9(5): 293-298.
https://doi.org/10.4103/idoj.IDOJ_140_18
Langford DT, Burke C, Robertson K. Risk factors in onychocryptosis. Br J Surg 1989; 76(1): 45-48.
https://doi.org/10.1002/bjs.1800760116
Cho SY, Kim YC, Choi JW. Epidemiology and bone-related comorbidities of ingrown nail: a nationwide population-based study. J Dermatol 2018; 45(12): 1418-1424.
https://doi.org/10.1111/1346-8138.14621
Kose O, Celiktas M, Kisin B, et al. Is there a relationship between forefoot alignment and ingrown toenail? A case-control study. Foot Ankle Spec 2011; 4(1): 14-17.
https://doi.org/10.1177/1938640010387411
Ezekian B, Englum BR, Gilmore BF, et al. Onychocryptosis in the pediatric patient. Clin Pediatr (Phila) 2017; 56(2): 109-114.
https://doi.org/10.1177/0009922816679010
Khunger N, Kandhari R. Ingrown toenails. Indian J Dermatol Venereol Leprol 2012; 78(3): 279-289.
https://doi.org/10.4103/0378-6323.95442
Gera SK, Zaini DKH, Wang S, et al. Ingrowing toenails in children and adolescents: is nail avulsion superior to nonoperative treatment? Singapore Med J 2019; 60(2): 94-96.
https://doi.org/10.11622/smedj.2018072
Romero-Pérez D, Betlloch-Mas I, Encabo-Durán B. Onychocryptosis: a long-term retrospective and comparative follow-up study of surgical and phenol chemical matricectomy in 520 procedures. Int J Dermatol 2017; 56(2): 221-224.
https://doi.org/10.1111/ijd.13448
Freiberg A, Dougherty S. A review of management of ingrown toenails and onychogryphosis. Can Fam Physician 1988; 34: 2675-2681.
Daniel CR, Iorizzo M, Tosti A, et al. Ingrown toenails. Cutis 2006; 78(6): 407-408. https://doi.org/10.12788/cutis.0005
Muhammad Sajj AD, Asahraf F. Ingrowing toenail. Pak J Med Sci 2007; 23(1): 150-151.
https://doi.org/10.12669/pjms.231.3739
Kuru I, Sualp T, Ferit D, et al. Factors affecting recurrence rate of ingrown toenail treated with marginal toenail ablation. Foot Ankle Int 2004; 25(6): 410-413.
https://doi.org/10.1177/107110070402500606
Khan AA, Kumar S. Results of Winograd technique (wedge resection of the toenail and nail bed) in ingrown toenail. Int Surg J 2019; 6(7): 2349-2352.
https://doi.org/10.18203/2349-2902.isj20193005
Mousavi SR, Beygi AN, Raeeszadeh M. Simple surgical technique for ingrown toenail surgery. Iran J Dermatol 2009; 12(2): 86-89. https://doi.org/10.22034/ijd.2009.1008
Huang JZ, Zhang YJ, Ma X, et al. Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails. J Foot Ankle Surg 2015; 54(3): 395-398.
https://doi.org/10.1053/j.jfas.2014.06.008
Razak A, Ahmad M. Evidence-based treatment of ingrown toenails. In: Paediatric Orthopaedics. Springer; 2017. p. 495-498. https://doi.org/10.1007/978-3-319-40342-6_44
Dąbrowski M, Litowińska A. Recurrence and satisfaction with sutured surgical treatment of an ingrown toenail. Ann Med Surg (Lond) 2020; 56: 152-160.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Junaid Ashraf, Syed Mukarram Hussain, Syed Talha Hassan Gilani, Rizwan Ahmed, Shakeel Ahmed Zia, Sultan Ahmed Minhas
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
