Approach to ingrowing toenails: the wedge resection/segmental phenolization combination treatment

Area of Science:

• Podiatric surgery
• Dermatological surgery

Background:

• Ingrowing toenails (onychocryptosis) are a common condition causing significant pain and potential infection.
• Traditional treatments include wedge resection (WR) and segmental phenolization (SP), each with varying recurrence rates and pain levels.

Purpose of the Study:

• To compare the efficacy of wedge resection (WR), segmental phenolization (SP), and a combination treatment (WR/SP) for ingrowing toenails.
• To evaluate postoperative pain duration and intensity, and recurrence rates for each treatment modality.

Main Methods:

• A randomized controlled trial involving 140 patients with ingrowing toenails.
• Patients were allocated to three groups: WR (55 procedures), SP (53 procedures), or WR/SP (62 procedures).
• Follow-up was conducted for 6 months, monitoring pain and recurrence rates.

Main Results:

• The WR/SP group experienced significantly less postoperative pain (9.4 h) compared to the WR group (30.0 h, P < 0.001).
• No recurrences were observed in the WR/SP group, versus seven in the WR group and four in the SP group.
• The WR/SP group showed statistically significant lower recurrence rates compared to WR (P < 0.01) and SP (P < 0.05).

Conclusions:

• The combination of wedge resection and segmental phenolization (WR/SP) is a superior treatment for ingrowing toenails.
• This combined procedure offers reduced postoperative pain and a lower recurrence rate.
• WR/SP provides a more effective and durable solution for onychocryptosis management.