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Opioid Prescribing Patterns Associated with Selective Matrixectomies for Toenail Onychocryptosis: A TriNetX Analysis
Alexa S Podolsky1, Jose W Ricardo2, Tracey C Vlahovic3
1Renaissance School of Medicine, Stony Brook University, New York, NY, USA.
Skin Appendage Disorders
|July 31, 2026
Summary
Opioid prescribing after selective matrixectomy for ingrown toenails is common, with rates decreasing over time. Factors like sex, age, race, and prior health conditions influence whether patients receive opioids post-procedure.
Area of Science:
- Podiatric surgery
- Pain management
- Pharmacology
Background:
- Selective matrixectomy is a common procedure for ingrown toenails (onychocryptosis).
- Postoperative pain is typically mild-to-moderate and manageable with non-opioid analgesics.
- Understanding opioid prescribing patterns is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the rates of opioid prescribing following selective matrixectomy.
- To identify demographic and clinical factors associated with opioid prescribing after this procedure.
- To guide physicians in patient counseling regarding postoperative pain management.
Main Methods:
- Retrospective cohort study using the TriNetX research network.
- Analysis of 97,208 patients undergoing selective matrixectomy for onychocryptosis.
- Cox regression used to identify factors associated with opioid prescriptions within 3 days postoperatively.
Main Results:
- 15.2% of patients received an opioid prescription within 3 days of surgery.
- Opioid prescribing rates declined from 24.3% (2008-2018) to 12.8% (2018-2025).
- Factors influencing prescribing included sex, age, race, ethnicity, and comorbidities such as anxiety, depression, and fibromyalgia.
Conclusions:
- Opioid prescribing after selective matrixectomy is prevalent and potentially exceeds clinical necessity.
- Prescribing patterns are influenced by patient-specific demographic and clinical factors.
- There is an opportunity to refine postoperative pain management strategies for selective matrixectomy patients.
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