Search Our Scientific Publications & Authors

J Am Podiatr Med Assoc 2019 Sep;109(5):401-406

Onychocryptosis is a common pathology treated by podiatry medical services, and in a considerable percentage, surgical procedures are required to achieve a solution. There are multiple surgical approaches for ingrown toenails, both incisional procedures and nonincisional procedures, such as chemical matrixectomies and physical matrixectomies using carbon dioxide laser. This study presents a surgical procedure for onychocryptosis using a physical matrixectomy with a 1064-nm laser applied by means of a 400-μm optical fiber and surgical removal of the posterior cauterized tissue to achieve healing by primary intention. Read More

Dermatol Pract Concept 2018 Jan 31;8(1):22-27. Epub 2018 Jan 31.

Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

Background: Our routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of excision based on our experience without an objective standard and routinely performed avulsion of the nail plate.

Objective: To take the nail plate as an objective mark during surgical treatment of ingrown toenail to ensure accurate excision. Read More

JAMA Dermatol 2017 04;153(4):325-326

Escuela Universitaria de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.

Acta Orthop Traumatol Turc 2016 ;50(3):262-8

Adana Numume Training and Research Hospital, Department of Dermatology, Adana, Turkey.

Objective: The aim of this study was to investigate the effectiveness of cryotherapy applied for the purpose of matricectomy following partial nail removal in treatment of ingrown nails.

Methods: Between 2010 and 2013, 76 ingrown toenails of 62 patients were included in this prospective study. Following partial toenail removal, matricectomy with cryotherapy was performed. Read More

Dermatol Clin 2015 Apr 15;33(2):277-82. Epub 2015 Feb 15.

Dermatologic Clinic, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil; Department of Dermatology, Medical School of ABC, São Paulo, Brazil.

Nail phenolization is considered a useful procedure for treating ingrowing toenails. Nail phenolization is indicated when partial and definitive removal of the nail plate is necessary. Nail phenolization is simple and inexpensive, and associated with little postoperative discomfort, a quick return to normal activities, and a low rate of complication and recurrence. Read More

Pak J Med Sci 2014 Nov-Dec;30(6):1425-7

Ozan Bitik, MD, Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Ingrown toenails are painful conditions that especially affect young people and may become chronic if not treated. We describe a case of chronically inflamed ingrown toenail left untreated for three years. In the physical examination, skin bridging and epithelialization was observed in midline secondary to soft tissue hypertrophy of the lateral nail matrixes. Read More

Pediatr Ann 2014 Nov;43(11):434-9

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Read More

Int J Low Extrem Wounds 2015 Jun 25;14(2):192-5. Epub 2014 Sep 25.

St Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon-si, Korea

The aim of this study was to compare the result of electrocauterization and curettage, which can be done with basic instruments. Patients with ingrown nail were randomized to 2 groups. In the first group, nail matrix was removed by curettage, and the second group, nail matrix was removed by electrocautery. Read More

Dermatol Ther 2014 Nov-Dec;27(6):369-72. Epub 2014 Jul 14.

Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.

For treatment of ingrown toenails, a phenolization approach is often chosen. Many reports describe a lavage of the wound with alcohol to neutralize any residual phenol; however, it remains uncertain if there is a more effective solution for use in the lavage step. The aim of our study was to analyze the suitability and effectiveness of 0. Read More

Indian J Dermatol 2013 Jul;58(4):327

Department of Orthopedics Surgery, Bozok University Medical Faculty, Yozgat, Turkey.

Background: Ingrown toenails (IT) is a very common problem leading to significant associated morbidity. The articles related to phenolization for matrix removal in teenagers with IT are not enough in the foot surgery literature.

Aims: To compare the postoperative recovery periods, complication rate, and tolerability of partial matrix excision and segmental phenolization in teenagers with IT. Read More

Eur J Dermatol 2013 May-Jun;23(3):319-23

Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Avda. Atenas s/n 28006 Alcorcon, Madrid, Spain.

Background: For treatment of ingrown toenails, a phenolization is often chosen. Many reports describe an intra-operative irrigation, or lavage, of the wound with alcohol to neutralize any residual phenol. There are conflicting reports in the literature as to whether a true neutralization is required or merely effective removal of excess phenol. Read More

Rom J Morphol Embryol 2013 ;54(2):253-9

Department of Pathology, Hospital El Bierzo, Ponferrada, Spain.

The success of surgical approaches to ingrown toenails depends on the extraction (either partial or total) of the nail matrix. The identification of the nail matrix in specimens taken from ingrown toenails is not always easy because of the fragmentation of the biopsies, difficulties in matrix orientations and the heavy inflammatory infiltrate. In biopsies taken from polydactyly surgeries, the matrix shows a peculiar pattern of expression of the CD10 and CD34 markers that differs from the one shown by the lateral nail fold. Read More

Dermatol Surg 2013 Sep 2;39(9):1363-7. Epub 2013 May 2.

Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.

Background: A phenolization approach is often chosen for treatment of ingrown toenails. Many reports describe lavage of the wound with alcohol to neutralize any residual phenol. The aim of our study was to compare the suitability and effectiveness of a solution consisting of alcohol plus chlorhexidine with that of alcohol alone in a lavage step during the treatment of ingrown toenails using a phenolization procedure. Read More

Dermatol Surg 2012 Aug;38(8):1296-301

Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain.

Background: Phenol cauterization is a chemical equivalent often chosen for treatment of ingrown toenails. Many reports describe intraoperative irrigation, or lavage, of the wound with various types of alcohol to neutralize any remaining phenol. There are conflicting reports in the literature as to whether true neutralization or merely effective removal of excess phenol is needed. Read More

J Am Podiatr Med Assoc 2012 May-Jun;102(3):198-204

Heymin General Hospital, 627-3, Jayang dong, Gwangjingu, Seoul, 443-191, Republic of Korea.

Background: Severely incurved toenails are accompanied by deformity of the toenail growth plate. In such a condition, partial removal of the nail and nail bed and simple unfolding of the nail itself frequently result in the recurrence of symptoms. We sought to design and develop a new technique for the treatment of incurved toenail with growth plate deformity and to report the results of treating this disease entity. Read More

Cochrane Database Syst Rev 2012 Apr 18(4):CD001541. Epub 2012 Apr 18.

Department of Public Health and Primary Care, Leiden University Medical Center, Leiden,

Background: Ingrowing toenails are a common problem in which part of the nail penetrates the skinfold alongside the nail, creating a painful area. Different non-surgical and surgical interventions for ingrowing toenails are available, but there is no consensus about a standard first-choice treatment.

Objectives: To evaluate the effects of non-surgical and surgical interventions in a medical setting for ingrowing toenails, with the aim of relieving symptoms and preventing regrowth of the nail edge or recurrence of the ingrowing toenail. Read More

J Am Acad Dermatol 2011 Feb 26;64(2):328-35. Epub 2010 Nov 26.

Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.

Background: A common challenge of nail avulsion surgery is the associated bacterial contamination and infection that can manifest. The toe has a difficult anatomy to antiseptically prepare and properly maintain throughout the surgical procedure, lending to this widespread problem.

Objective: We conducted a controlled, prospective randomized study to examine the antiseptic efficacy of 3 intraoperative irrigation methods during nail avulsion surgery. Read More

J Eur Acad Dermatol Venereol 2011 Jul 6;25(7):794-8. Epub 2010 Oct 6.

Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.

Background: For treatment of ingrown toenails, a phenolization is often chosen. Many reports describe an intra-operative irrigation or lavage of the wound with various types of alcohol to neutralize any residual phenol from this treatment. There are conflicting reports in the literature as to whether a true neutralization is required or merely effective removal of excess phenol. Read More

Ann Dermatol Venereol 2010 Oct 1;137(10):645-7. Epub 2010 Sep 1.

CHU Ibn Rochd, Casablanca, Maroc.

Background: Retronychia is the phenomenon of ingrown nail resulting in inflammation of the proximal subungual fold and is a newly described entity. Herein, we report a new case revealed through chronic proximal perionyxis.

Patients And Methods: A 52-year-old woman followed up for hypothyroidism, for which she was receiving treatment, consulted for pain in the lateral fold of the left big toe that had been ongoing for four months and for which glomic tumour was the suspected cause. Read More

Dermatol Online J 2009 Jul 15;15(7):12. Epub 2009 Jul 15.

We report on a 63-year-old male who suffered from an ingrown toenail affecting the left first digit for several years. Medical history revealed that repeated vigorous nail plate trimming by the patient relieve the red, painful swelling of his great toe. Furthermore, Emmert onychoplasty as well as non-invasive procedures did not achieve improvement. Read More

Acta Orthop Traumatol Turc 2009 Aug-Oct;43(4):298-302

Department of Dermatology, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Objectives: Partial nail avulsion with phenol matricectomy is one of the most widely performed procedures for the treatment of ingrowing nails. We compared phenol applications of different durations with respect to efficacy and safety.

Methods: The study included 148 ingrowing nails (grade 2-3) of 110 patients (54 males, 56 females). Read More

Acta Orthop Traumatol Turc 2008 May-Jul;42(3):174-7

Mareşal Cakmak Asker Hastanesi, Ortopedi ve Travmatoloji Bölümü.

Objectives: Ingrowing toe nail is a frequent disorder of the foot. In this study, we evaluated the results of surgical treatment of ingrowing toe nail.

Methods: Sixty-two patients (31 males, 31 females; mean age 38 years; range 11 to 72 years) with ingrowing toe nail underwent partial removal of the nail matrix according to the Winograd technique. Read More

J Plast Reconstr Aesthet Surg 2009 Oct 3;62(10):1327-30. Epub 2008 Aug 3.

Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan 430022, China.

The aim of this study was to identify putative aetiological factors of recalcitrant ingrown toenail and then to introduce a new surgical technique for its treatment on the basis of this identification. We found that many of our patients had an upturned morphology on the distal phalanx beneath the recalcitrant ingrown toenail. We thereby designed a new operative technique to treat this problem. Read More

Can J Rural Med 2005 ;10(3):173-80

Department of Family Practice, University of British Columbia Faculty of Medicine, Vancouver, BC.

The ingrowing toenail is a painful foot condition that can be treated by most rural physicians. If it is not too severe, conservative management can be initiated first. If the situation is not improving or is worsening, removal of the nail plate with destruction of the nail matrix, by either surgical or chemical matricectomy, is indicated. Read More

Cochrane Database Syst Rev 2005 Apr 18(2):CD001541. Epub 2005 Apr 18.

UK Cochrane Centre, Summertown Pavilion, Middle Way, Oxford, Oxfordshire, UK, OX2 7LG.

Background: Ingrowing toenails are a common condition which, when recurrent and painful, are often treated surgically.

Objectives: To evaluate the effectiveness of methods of the surgical treatment of ingrowing toenails.

Search Strategy: Electronic database searching (CENTRAL, MEDLINE, EMBASE, CINAHL) followed by investigation of reference lists of the papers identified from the initial search. Read More

J Cosmet Laser Ther 2004 May;6(1):38-40

Department of Dermatology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the University of Dresden, Dresden, Germany.

Background: Ingrowing nails are a common problem. Standard procedure is surgery according to Emmet (a gynecologist) or Emmert (a surgeon) where postoperative pain, swelling and bleeding are major side effects and traumatic damage of the nail organ is not completely avoidable. Laser surgery may provide an alternative with less tissue damage. Read More

Scand J Plast Reconstr Surg Hand Surg 2004 ;38(3):155-9

Department of Plastic and Reconstructive Surgery, Akita Red Cross Hospital, Akita, Japan.

A number of operations have been devised to treat ingrowing toenails and pincer nails, and they have given good aesthetic and functional results. However, there have been few reports of operations for the treatment of severe nail deformities caused by damage to the matrix of the nail by injury, or by inappropriate removal of the nail or intractable onychomycosis or cardiovascular or neurological disorders. In 1950, Zadik reported a radical technique for ingrown nails and pincer nails: after avulsion of the nail, the matrix was excised completely and the posterior nail wall was sutured to the nail bed as an advancement flap. Read More

Ann Plast Surg 2004 Jun;52(6):617-20

Division of Plastic Surgery, Campus Bio-Medico University, Rome, Italy.

Many treatment modalities of ingrown toenail are reported in the literature, often associated with unacceptably high recurrence rate. The authors present their technique, which aims at reducing the convexity of the nail fold. After complete removal of the nail plate and accurate debridement of the granulomatous tissue, a wedge-shaped ellipsis of skin and subcutaneous tissue, lateral to the affected nail fold, is removed. Read More

Dermatol Surg 2003 Jul;29(7):745-8

Department of Dermatology, College of Medicine, Chosun University, Gwangju, Korea.

Background: An ingrown nail is a common disorder that occurs most frequently in the great toe and causes much discomfort in patients. Although many therapeutic methods have been described, most of them can lead to severe damage to the nail or to frequent relapses. The nail-splinting technique is known to be a noninvasive therapeutic method for treating an ingrown nail. Read More

Hand Clin 2002 Nov;18(4):693-6, viii; discussion 697

Nail Disease Centre, 42 rue des Serbes, 06400, Cannes, France.

Matricectomy refers to the complete extirpation of the nail matrix, resulting in permanent nail loss. Usually however, matricectomy is only partial, restricted to one or both lateral horns of the matrix. Nail ablation is the definitive removal of the entire nail organ. Read More

J Am Podiatr Med Assoc 2002 Nov-Dec;92(10):575-9

American Board of Podiatric Surgery, USA.

Chemical matrixectomy using phenol is one of the most common surgical procedures for the permanent removal of toenails. The concentration of phenol solution and duration of its application have varied widely and have not been subjected to scientific study. The authors studied the histologic effects of phenol on the nail matrix and determined the optimal concentration of phenol and time the phenol solution needs to be in contact with the nail bed. Read More

Am Fam Physician 2002 Jun;65(12):2557-8

Am Fam Physician 2002 Jun;65(12):2547-52, 2554

Saginaw Cooperative Hospital, Michigan, USA.

Ingrown toenail is a common problem resulting from various etiologies including improperly trimmed nails, hyperhidrosis, and poorly fitting shoes. Patients commonly present with pain in the affected nail but with progression, drainage, infection, and difficulty walking occur. Excision of the lateral nail plate combined with lateral matricectomy is thought to provide the best chance for eradication. Read More

J Dermatol 2001 Sep;28(9):485-9

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Ingrown toenail is a common problem, and currently available treatments are either quite invasive or associated with unacceptably high recurrence rate. Recently a new non-invasive therapy. "Nail splinting", has been introduced. Read More

Burns 2001 May;27(3):289-92

Department of Plastic Surgery, Shotley Bridge Hospital, Shotley Bridge, County Durham DH8 0NB, UK.

Ingrowing toenails, onychocryptosis, are a common condition that can be treated conservatively or surgically. Conservative treatment often fails necessitating operative intervention. Surgical treatments include wedge resection, Zadik's procedure and nail removal with ablation of the germinal matrix by phenol. Read More

Cochrane Database Syst Rev 2000 (2):CD001541

UK Cochrane Centre, Summertown Pavilion, Middle Way, Oxford, Oxfordshire, UK, OX2 7LG.

Objectives: To evaluate the effectiveness of methods of the surgical treatment of ingrowing toenails.

Search Strategy: Electronic database searching (CENTRAL, MEDLINE, EMBASE, CINAHL) followed by investigation of reference lists of the papers identified from the initial search.

Selection Criteria: Any randomised (or quasi-randomised) controlled trial which compares one form of surgical removal of all or part of a toenail due to its impact on the soft tissues to another or others. Read More

J Cutan Med Surg 1999 Oct;3(6):324-35

Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.

BACKGROUND: Nail surgery can be performed in an office-based dermatology practice with a limited amount of specialized equipment and training. Several excellent reviews have been published in recent years that detail the techniques of nail surgery for both the novice and the experienced practitioner. OBJECTIVE: In this article recent developments in nail surgery are discussed. Read More

J Dermatol Surg Oncol 1992 Aug;18(8):728-34

Department of Dermatology, University of Iowa, Iowa City.

Removal of the nail matrix is indicated in a variety of recalcitrant conditions in which the growth of the nail plate causes mechanical problems such as recurrent onychocryptosis or pain due to pinching or pressure. Before performing a matricectomy, the physician must consider the use of nonsurgical methods and the possible contraindications to surgery. Once the decision for matricectomy is made, the physician should then utilize the modality with the least morbidity and greatest convenience for the patient. Read More

Z Orthop Ihre Grenzgeb 1992 Jul-Aug;130(4):323-32

Orthopädische Abteilung des St. Petrus-Krankenhauses Bonn.

Report on proven methods of operation for the typical foot diseases. Particular emphasis is put on the possibilities for correction of many deformities of the foot through Chopart-arthrodesis by corresponding wedge-removal from the root of the foot, as underlined by Imhäuser. The Chopart-arthrodesis is especially suitable for treating weight-bearing complaints of mal-healed fractures of the calcaneum, because this procedure stabilizes the hindfoot and sets the mid- and forefoot plantarly. Read More

Clin Podiatr Med Surg 1989 Apr;6(2):453-67

Department of Surgery, New York College of Podiatric Medicine, New York.

The phenol and alcohol procedure still remains as one of the most effective and gratifying means of treatment for symptomatic ingrown nails. Most of the literature is concerned with length and manner of application and various forms of postoperative management. Several points must be stressed. Read More

Clin Podiatr Med Surg 1989 Apr;6(2):431-51

St. Alban's Veterans Hospital Residency Program, Seaford, New York.

As the so-called "non-surgical" nail procedures grow more and more aggressive and invasive in nature, the cold steel matrixectomy becomes an increasingly viable alternative. Many chemical and thermal matrixectomies are performed under poor aseptic conditions, increasing the risk of wound infection. With chemical matrixectomy, regulation of the level of tissue destruction is uncontrolled and often results in bone injury. Read More

Padiatr Padol 1985 ;20(2):173-6

In the years from 1973-1983, 36 children, ranging in ages from 14 days to 4 years, with ingrown toenails, which they had had since birth, were admitted for stationary treatment. For 26 of the children, the nails of both large toes were ingrown. In eight cases the smear from the nail wall revealed pathological germs of differing types. Read More

Z Hautkr 1982 Aug;57(15):1107-16

Operations of the nail apparatus are done under sterile conditions and regional anaesthesia and in local anaemia. The knowledge of the complicated anatomy and physiology is the prerequisite for good surgical results. Nail extractions are commonly done too frequently. Read More

J Am Podiatry Assoc 1970 Oct;60(10):406-7

Calif Med 1962 Oct;97:222-6

Appropriate office treatment for "ingrown" or deformed toenails can bring quick and lasting relief. The principle is the removal of the portion of the nail that irritates. For mild problems, a buried nail corner or spur may be successfully trimmed away without anesthesia. Read More

R I Med J 1957 Nov;40(11):626-7

J Natl Assoc Chirop 1947 Nov;37(11):27