Ingrowing Nail Correction by Advancing Composite Flap of the Nailbed and Periosteum—A Simple and Effective Technique
Affiliation(s)
Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Sultanate of Oman.
Department of Plastic, Reconstructive and Craniofacial Surgery, Khoula Hospital, Muscat, Sultanate of Oman.
ABSTRACT
Ingrowing toenails are common particularly in young adults. They usually result in a prolonged period of discomfort or pain that is sufficient to interfere with working and social activities. Apart from the toes, ingrowing nails can affect the fingers as well. Surgery is still the mainstay of treatment. A number of techniques have been described in the literature. But in all there is a high recurrence rate and sometimes the cosmetic result is not acceptable. In this article we describe our technique of surgical management of ingrowing nails of the toes and fingers. The technique involves excision of a part of the lateral nail fold and raising a composite flap consisting of the nail bed and the underlying periosteum which is then advanced. 105 cases were operated using this technique with very good postoperative results.
Cite this paper
Hashish, A. , Habib, M. and Al-Busaidi, S. (2014) Ingrowing Nail Correction by Advancing Composite Flap of the Nailbed and Periosteum—A Simple and Effective Technique. Modern Plastic Surgery, 4, 26-31. doi: 10.4236/mps.2014.42006.
Hashish, A. , Habib, M. and Al-Busaidi, S. (2014) Ingrowing Nail Correction by Advancing Composite Flap of the Nailbed and Periosteum—A Simple and Effective Technique. Modern Plastic Surgery, 4, 26-31. doi: 10.4236/mps.2014.42006.
References
[1] Bostanci, S., Ekmekci, P. and Gurgey, E. (2001) Chemical Matricectomy with Phenol for the Treatment of Ingrowing Toenail: A Review of the Literature and Follow Up of 172 Treated Patients. Acta Dermato-Venereologica, 81, 181-183. http://dx.doi.org/10.1080/000155501750376267 [2] Abby, N.S., Roni, P., Amnon, B. and Yan, P. (2002) Modified Sleeve Method Treatment of Ingrowing Toenail. Dermatologic Surgery, 28, 852-855. http://dx.doi.org/10.1046/j.1524-4725.2002.02040.x [3] Peyvandi, H., Robati, R.M., Yegane, R., Hajinasrollah, E., Toossi, P., Peyvandi, A., Ourang, Z.B. and Shams, A. (2011) Comparison of Two Surgical Methods (Winograd and Sleeve Method) in the Treatment of Ingrown Toenail. Dermatologic Surgery, 37, 331-335. http://dx.doi.org/10.1111/j.1524-4725.2011.01880.x [4] Mitchell, S., Jackson, C.R. and Wilson-Storey, D. (2011) Surgical Treatment of Ingrown Toenails in Children: What Is Best Practice. Annals of the Royal College of Surgeons of England, 93, 99-102. http://dx.doi.org/10.1308/003588411X12851639107674 [5] Ozdil, B. and Eray, I.G. (2009) New Method Alternative to Surgery for Ingrown Nail: Angle Correction Technique. Dermatologic Surgery, 35, 990-992. http://dx.doi.org/10.1111/j.1524-4725.2009.01169.x [6] Sonnex, T.S. and Dwber, R.P.R. (1985) Treatment of Ingrowing Toenails with Liquid Nitrogen Spray Cryotherapy. British Medical Journal, 291,173-175. http://dx.doi.org/10.1136/bmj.291.6489.173 [7] Tweedie, J.H. and Ranger, I. (1985) A Simple Procedure with Nail Preservation for Ingrowing Toe-Nails. Archives of Emergency Medicine, 2, 149-154. http://dx.doi.org/10.1136/emj.2.3.149 [8] Mansavi, S.R. and Khoshmevice, J. (2012) A New Surgical Technique for Ingrowing Toenail. International Scholarly Research Network, 1-4. [9] Haneke, E. (2012) Controversies in the Treatment of Ingrown Nails. Dermatology Research and Practice, 1-12. http://dx.doi.org/10.1155/2012/783924 [10] Farrelly, P.J., Minford, J. and Jones, M.O. (2011) Surgical Treatment of Ingrown Toenails in Children. Annals of the Royal College of Surgeons of England, 93, 99-102. http://dx.doi.org/10.1308/003588 411X572231 [11] Nazari, S. (2006) A Simple and Practical Method in Treatment of Ingrown Nails: Splinting by Flexible Tube. JEADV, 20, 1302-1306. http://dx.doi.org/10.1111/j.1468-3083.2006.01793.x [12] Wollina, U. (2004) Modified Emmet’s Operation for Ingrown Nails Using the ER:YAG Laser. Journal of Cosmetic and Laser Therapy, 6, 38-40. http://dx.doi.org/10.1080/14764170410029077 [13] Chiacchio, N.D., Belda, W., Di Chiacc, N.G., Gabriel, F.V. and de Farias, D.G. (2010) Nail Matrix Phenolization for Treatment of Ingrowing Nail: Technique Report and Recurrence Rate of 267 Surgeries. Dermatologic Surgery, 36, 534-537. http://dx.doi.org/10.1111/j.1524-4725.2010.01490.x [14] Kosaka, M., Kusuhara, H., Mochizuki, Y., Mori, H. and Isogai, N. (2010) Morphologic Study of Normal, Ingrown, and Pincer Nails. Dermatologic Surgery, 36, 31-38. http://dx.doi.org/10.1111/j.1524-4725. 2009.01361.x [15] Palmer, B.V. and Jones, A. (1979) Ingrowing Toenails: The Results of Treatment. British Journal of Surgery, 66, 575-576. http://dx.doi.org/10.1002/bjs.1800660818 [16] Murray, W.R. and Bedi, B.S. (1975) The Surgical Management of Ingrowing Toenail. British Journal of Surgery, 62, 409-412. http://dx.doi.org/10.1002/bjs.1800620522 [17] Lloyd-Davies, R.W. and Brill, G.C. (1963) The Aetiology and Out-Patient Management of Ingrowing Toe-Nails. British Journal of Surgery, 50, 592-597. http://dx.doi.org/10.1002/bjs.18005022407 [18] Zadik, F.R. (1950) Obliteration of the Nail Bed of the Great Toe without Shortening of the Terminal Phalanx. Journal of Bone and Joint Surgery, 32-B, 66-67. [19] Chapeskie, H. (2008) Ingrown Toenail or Overgrown Toe Skin? Alternative Treatment for Onychocryptosis. Canadian Family Physician, 54, 1561-1562.
[1] Bostanci, S., Ekmekci, P. and Gurgey, E. (2001) Chemical Matricectomy with Phenol for the Treatment of Ingrowing Toenail: A Review of the Literature and Follow Up of 172 Treated Patients. Acta Dermato-Venereologica, 81, 181-183. http://dx.doi.org/10.1080/000155501750376267 [2] Abby, N.S., Roni, P., Amnon, B. and Yan, P. (2002) Modified Sleeve Method Treatment of Ingrowing Toenail. Dermatologic Surgery, 28, 852-855. http://dx.doi.org/10.1046/j.1524-4725.2002.02040.x [3] Peyvandi, H., Robati, R.M., Yegane, R., Hajinasrollah, E., Toossi, P., Peyvandi, A., Ourang, Z.B. and Shams, A. (2011) Comparison of Two Surgical Methods (Winograd and Sleeve Method) in the Treatment of Ingrown Toenail. Dermatologic Surgery, 37, 331-335. http://dx.doi.org/10.1111/j.1524-4725.2011.01880.x [4] Mitchell, S., Jackson, C.R. and Wilson-Storey, D. (2011) Surgical Treatment of Ingrown Toenails in Children: What Is Best Practice. Annals of the Royal College of Surgeons of England, 93, 99-102. http://dx.doi.org/10.1308/003588411X12851639107674 [5] Ozdil, B. and Eray, I.G. (2009) New Method Alternative to Surgery for Ingrown Nail: Angle Correction Technique. Dermatologic Surgery, 35, 990-992. http://dx.doi.org/10.1111/j.1524-4725.2009.01169.x [6] Sonnex, T.S. and Dwber, R.P.R. (1985) Treatment of Ingrowing Toenails with Liquid Nitrogen Spray Cryotherapy. British Medical Journal, 291,173-175. http://dx.doi.org/10.1136/bmj.291.6489.173 [7] Tweedie, J.H. and Ranger, I. (1985) A Simple Procedure with Nail Preservation for Ingrowing Toe-Nails. Archives of Emergency Medicine, 2, 149-154. http://dx.doi.org/10.1136/emj.2.3.149 [8] Mansavi, S.R. and Khoshmevice, J. (2012) A New Surgical Technique for Ingrowing Toenail. International Scholarly Research Network, 1-4. [9] Haneke, E. (2012) Controversies in the Treatment of Ingrown Nails. Dermatology Research and Practice, 1-12. http://dx.doi.org/10.1155/2012/783924 [10] Farrelly, P.J., Minford, J. and Jones, M.O. (2011) Surgical Treatment of Ingrown Toenails in Children. Annals of the Royal College of Surgeons of England, 93, 99-102. http://dx.doi.org/10.1308/003588 411X572231 [11] Nazari, S. (2006) A Simple and Practical Method in Treatment of Ingrown Nails: Splinting by Flexible Tube. JEADV, 20, 1302-1306. http://dx.doi.org/10.1111/j.1468-3083.2006.01793.x [12] Wollina, U. (2004) Modified Emmet’s Operation for Ingrown Nails Using the ER:YAG Laser. Journal of Cosmetic and Laser Therapy, 6, 38-40. http://dx.doi.org/10.1080/14764170410029077 [13] Chiacchio, N.D., Belda, W., Di Chiacc, N.G., Gabriel, F.V. and de Farias, D.G. (2010) Nail Matrix Phenolization for Treatment of Ingrowing Nail: Technique Report and Recurrence Rate of 267 Surgeries. Dermatologic Surgery, 36, 534-537. http://dx.doi.org/10.1111/j.1524-4725.2010.01490.x [14] Kosaka, M., Kusuhara, H., Mochizuki, Y., Mori, H. and Isogai, N. (2010) Morphologic Study of Normal, Ingrown, and Pincer Nails. Dermatologic Surgery, 36, 31-38. http://dx.doi.org/10.1111/j.1524-4725. 2009.01361.x [15] Palmer, B.V. and Jones, A. (1979) Ingrowing Toenails: The Results of Treatment. British Journal of Surgery, 66, 575-576. http://dx.doi.org/10.1002/bjs.1800660818 [16] Murray, W.R. and Bedi, B.S. (1975) The Surgical Management of Ingrowing Toenail. British Journal of Surgery, 62, 409-412. http://dx.doi.org/10.1002/bjs.1800620522 [17] Lloyd-Davies, R.W. and Brill, G.C. (1963) The Aetiology and Out-Patient Management of Ingrowing Toe-Nails. British Journal of Surgery, 50, 592-597. http://dx.doi.org/10.1002/bjs.18005022407 [18] Zadik, F.R. (1950) Obliteration of the Nail Bed of the Great Toe without Shortening of the Terminal Phalanx. Journal of Bone and Joint Surgery, 32-B, 66-67. [19] Chapeskie, H. (2008) Ingrown Toenail or Overgrown Toe Skin? Alternative Treatment for Onychocryptosis. Canadian Family Physician, 54, 1561-1562.