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07:41
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
[Ingrown toenail]
J F Anne Schellekens1, Debora A B Werson, Jan Wille
1St. Antonius Ziekenhuis, Afd. Chirurgie, Nieuwegein, The Netherlands. a.schellekens@antoniusziekenhuis.nl
Nederlands Tijdschrift Voor Geneeskunde
|April 2, 2010
Summary
Ingrown toenail surgery can lead to serious complications in patients with peripheral arterial disease (PAD). Screening for PAD using the ankle-brachial index is crucial before ingrown toenail treatment.
Area of Science:
- Podiatric surgery
- Vascular medicine
- Dermatology
Background:
- Ingrown toenails (onychocryptosis) are common, often treated surgically.
- Peripheral arterial disease (PAD) affects circulation, potentially complicating wound healing.
- Standard ingrown toenail procedures may have adverse outcomes in PAD patients.
Observation:
- Three male patients (58, 79, 78 years) with hallux onychocryptosis underwent partial nail extraction and phenolisation.
- Post-operative wound healing failed, with worsening symptoms.
- Ankle-brachial index (ABI) < 0.9 indicated PAD, confirmed by imaging (ultrasonography, CT, MRA).
Findings:
- One patient required hallux amputation due to insufficient circulation after endovascular arterial dilatation.
- Two patients recovered after bypass surgery (femorofibular and femoropopliteal).
- Undiagnosed PAD significantly increases risks associated with ingrown toenail surgery.
Implications:
- Pre-operative screening for PAD is essential for patients undergoing ingrown toenail surgery.
- Ankle-brachial index (ABI) measurement is recommended; toe pressure waves for diabetics.
- Referral to a vascular surgeon is necessary if PAD is detected before podiatric intervention.
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