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Recurrent Onychocryptosis Treated With the Winograd Procedure: A Case Report
Aaron D McCusker1, Conn Rooney2, Joshua Letch3
1Podiatric Surgery, East Suffolk and North Essex NHS Foundation Trust, Ipswich, GBR.
Abstract:
Onychocryptosis is a common disorder of the nail unit in which the nail plate penetrates the surrounding periungual soft tissue. This often results in pain, inflammation, and potential infection. While conservative and non-incisional surgical treatments such as partial nail avulsion with chemical matrixectomy are often effective, recurrence may occur and can significantly impact the patient's quality of life. Chronic or recurrent cases may therefore require more definitive surgical management. We present the case of a 22-year-old male patient with recurrent onychocryptosis of the right hallux following failed partial nail avulsion and phenol matrixectomy. The patient subsequently underwent incisional nail surgery using the Winograd procedure. Postoperative recovery was uncomplicated with the patient returning to normal footwear within two weeks. At the 12-month follow-up, the hallux was fully healed with no evidence of nail regrowth or recurrence. The patient reported complete resolution of symptoms and was highly satisfied with the outcome. This case demonstrates that surgical excision with partial matrixectomy using the Winograd technique can provide a safe and effective long-term solution for recurrent onychocryptosis when less invasive interventions have failed.
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